MEDICARE: MOLLY TRUAX URIBE NP-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	363L00000X	Nurse Practitioner	78072	KS
2	363L00000X	Nurse Practitioner	2018031876	MO

General Provider Information

NPI Number	:	1760980866
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOLLY TRUAX URIBE NP-C

Provider Business Mailing Address
First Line	:	4603 NE 83RD TER
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64119-7618
Country	:	US
Telephone Number	:	501-410-3722
Fax Number	:

Provider Business Practice Location Address
First Line	:	1202 N 38TH ST
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66102-2229
Country	:	US
Telephone Number	:	913-777-7600
Fax Number	:

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

Provider Enumeration Date	:	01/24/2018
Last Update Date	:	05/06/2024

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Directions to “ MOLLY TRUAX URIBE NP-C” Practice Location

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