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NPI Code Detail

MEDICARE: MS. VICTORIA RAYNOR FNP-BC

MEDICARE: MS. VICTORIA RAYNOR FNP-BC
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 Practitioner2013004688MO
2363LF0000XFamily Nurse Practitioner5375827KS

General Provider Information

NPI Number : 1851632582
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. VICTORIA RAYNOR FNP-BC
Provider Business Mailing Address
First Line : PO BOX 505321
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63150-5321
Country : US
Telephone Number : 816-502-7000
Fax Number :
Provider Business Practice Location Address
First Line : 14955 W 151ST ST
Second Line :
City : OLATHE
State : KS
Zip : 66062-3110
Country : US
Telephone Number : 913-323-8890
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2013
Last Update Date : 09/20/2016

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Directions to “ MS. VICTORIA RAYNOR FNP-BC” Practice Location

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