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NPI Code Detail

MEDICARE: MRS. JUNE ANN HUMPHREY FNP

MEDICARE:  MRS. JUNE ANN  HUMPHREY  FNP
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 Practitioner045264MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1861469090
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JUNE ANN HUMPHREY FNP
Provider Business Mailing Address
First Line : 1810 NE 79TH CT
Second Line :
City : KANSAS CITY
State : MO
Zip : 64118-1579
Country : US
Telephone Number : 816-810-3728
Fax Number :
Provider Business Practice Location Address
First Line : 1810 NE 79TH CT
Second Line :
City : KANSAS CITY
State : MO
Zip : 64118-1579
Country : US
Telephone Number : 816-810-3728
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/07/2006
Last Update Date : 08/06/2009

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