MEDICARE: DR. CHRISTINE I NEDEAU MD, FAAFP

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	207Q00000X	Family Medicine Physician	0000747	CO
2	207Q00000X	Family Medicine Physician	2002022546	MO
3	207Q00000X	Family Medicine Physician	61535	AZ
4	207Q00000X	Family Medicine Physician	0441013	KS
5	207Q00000X	Family Medicine Physician	MD2002022546	MO

General Provider Information

NPI Number	:	1346232592
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTINE I NEDEAU MD, FAAFP

Provider Business Mailing Address
First Line	:	9787 N CEDAR AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64157-6208
Country	:	US
Telephone Number	:	816-408-3717
Fax Number	:	816-429-9762

Provider Business Practice Location Address
First Line	:	9787 N CEDAR AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64157-6208
Country	:	US
Telephone Number	:	816-408-3717
Fax Number	:	816-429-9762

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

Provider Enumeration Date	:	08/15/2005
Last Update Date	:	04/05/2023

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