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Individual

DEANA J RABY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPNP

Contact information

Practice address
205 W R D MIZE RD, SUITE 304, BLUE SPRINGS, MO 64014-2518
(816) 228-4770
(816) 228-1156
Mailing address
205 W R D MIZE RD, SUITE 304, BLUE SPRINGS, MO 64014-2518
(816) 228-4770
(816) 228-1156

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
077428
MO
363LP0200X
Pediatric Nurse Practitioner
44356
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
428606818
MO
Enumeration date
12/01/2005
Last updated
01/31/2011
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