MEDICARE: EMILY HASTINGS

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	133V00000X	Registered Dietitian	2015044689	MO

General Provider Information

NPI Number	:	1821454604
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY HASTINGS

Provider Business Mailing Address
First Line	:	17501 E US HIGHWAY 40
Second Line	:
City	:	INDEPENDENCE
State	:	MO
Zip	:	64055-5442
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3800 S WHITNEY AVE STE 200
Second Line	:
City	:	INDEPENDENCE
State	:	MO
Zip	:	64055-6739
Country	:	US
Telephone Number	:	816-478-4887
Fax Number	:

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

Provider Enumeration Date	:	01/08/2016
Last Update Date	:	01/08/2016

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Directions to “ EMILY HASTINGS ” Practice Location

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