MEDICARE: MS. SANDRA RISNER WHNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LW0102X	Women's Health Nurse Practitioner	100490	MO

General Provider Information

NPI Number	:	1194700518
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SANDRA RISNER WHNP

Provider Business Mailing Address
First Line	:	8380 N TULLIS AVE STE 300
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64158-5114
Country	:	US
Telephone Number	:	816-741-9122
Fax Number	:	816-741-9665

Provider Business Practice Location Address
First Line	:	8380 N TULLIS AVE STE 300
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64158-5114
Country	:	US
Telephone Number	:	816-741-9122
Fax Number	:	816-741-9665

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2005
Last Update Date	:	04/29/2019

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