MEDICARE: EVELYN I. DEAN RN, ACNS-BC

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	364S00000X	Clinical Nurse Specialist	104464	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306826383
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EVELYN I. DEAN RN, ACNS-BC

Provider Business Mailing Address
First Line	:	4330 WORNALL RD
Second Line	:	SUITE 2000
City	:	KANSAS CITY
State	:	MO
Zip	:	64111-3201
Country	:	US
Telephone Number	:	816-931-1883
Fax Number	:	816-931-0422

Provider Business Practice Location Address
First Line	:	4330 WORNALL RD
Second Line	:	SUITE 2000
City	:	KANSAS CITY
State	:	MO
Zip	:	64111-3201
Country	:	US
Telephone Number	:	816-931-1883
Fax Number	:	816-931-0422

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

Provider Enumeration Date	:	01/18/2006
Last Update Date	:	01/22/2013

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