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NPI Code Detail

MEDICARE: DEBRA E MCCONVILLE ARNP, BC, CDE

MEDICARE: DEBRA E MCCONVILLE ARNP, BC, CDE
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
1363LA2200XAdult Health Nurse Practitioner091424MO

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00924438OTHERMORAILROAD MEDICARE PTAN

General Provider Information

NPI Number : 1437193133
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBRA E MCCONVILLE ARNP, BC, CDE
Provider Business Mailing Address
First Line : 2790 CLAY EDWARDS DR STE 1250
Second Line : C/O HELLMAN & ROSEN ENDOCRINE
City : NORTH KANSAS CITY
State : MO
Zip : 64116-3260
Country : US
Telephone Number : 816-421-3700
Fax Number : 816-421-1654
Provider Business Practice Location Address
First Line : 2790 CLAY EDWARDS DR STE 1250
Second Line : C/O HELLMAN & ROSEN ENDOCRINE
City : NORTH KANSAS CITY
State : MO
Zip : 64116-3260
Country : US
Telephone Number : 816-421-3700
Fax Number : 816-421-1654
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2006
Last Update Date : 05/20/2016

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1245523141 — AVIN POTHULOORI M.D.
Practice Location Address:
2790 CLAY EDWARDS DR STE 1250 , C/O HELLMAN & ROSEN ENDOCRINE
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64116-3260
Practice Phone: 816-421-3700
Practice Fax: 816-421-1654

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