MEDICARE: ADA GILLESPIE WENECK R.N.,L.P.C.

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	101YP2500X	Professional Counselor	002388	MO

General Provider Information

NPI Number	:	1467517722
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADA GILLESPIE WENECK R.N.,L.P.C.

Provider Business Mailing Address
First Line	:	PO BOX 22636
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64113-0636
Country	:	US
Telephone Number	:	816-444-5710
Fax Number	:	816-444-6425

Provider Business Practice Location Address
First Line	:	217 E 63RD ST
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64113-2224
Country	:	US
Telephone Number	:	816-444-5710
Fax Number	:	816-444-6425

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

Provider Enumeration Date	:	12/27/2006
Last Update Date	:	07/08/2007

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