Individual
MICHELLE L ROACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 234-3080
(816) 983-6633
Mailing address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 234-3080
(816) 983-6633
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
121088
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
073571
FAMILY HEALTH PARTNERS
—
05
—
428512339
—
MO
Enumeration date
07/07/2005
Last updated
12/23/2010
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