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NPI Code Detail

MEDICARE: LAJADA DOWNS APRN

MEDICARE: LAJADA DOWNS APRN
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
1363LF0000XFamily Nurse Practitioner2017042568MO
2363LF0000XFamily Nurse Practitioner5377976062KS

General Provider Information

NPI Number : 1801397203
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAJADA DOWNS APRN
Provider Business Mailing Address
First Line : 1914 SWIFT AVE
Second Line :
City : KANSAS CITY
State : MO
Zip : 64116-3447
Country : US
Telephone Number : 866-389-2727
Fax Number :
Provider Business Practice Location Address
First Line : 5440 NW 64TH ST
Second Line :
City : KANSAS CITY
State : MO
Zip : 64151-2415
Country : US
Telephone Number : 866-389-2727
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2018
Last Update Date : 12/14/2021

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