# RADIANCE HEALTH & WELLNESS CLINIC MO-KS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Radiance Health & Wellness
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407633902
- **Authorized official:** AMIE FABAH DNP (DR EZEOGU)
- **Authorized official phone:** (816) 510-4549

## Contact information

- **Practice address:** 6225 RAYTOWN TRFY, RAYTOWN, MO 64133-3846
- **Practice address phone:** (816) 510-4549
- **Mailing address:** 12641 ANTIOCH RD \# 1053, OVERLAND PARK, KS 66213-1701

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 09/11/2023
- **Last updated:** 07/29/2025