Individual
TARA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3801 BLUE PKWY, KANSAS CITY, MO 64130-2807
(816) 923-5800
Mailing address
7100 E 134TH TER, GRANDVIEW, MO 64030-3357
(816) 797-9353
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
78424
KS
363LA2200X
Adult Health Nurse Practitioner
Primary
2018032269
MO
Other
Enumeration date
03/02/2019
Last updated
02/22/2020
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