Individual
REBECCA K CAPTAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, BC, FNP-C
Contact information
Practice address
4330 WORNALL RD, SUITE 2000, KANSAS CITY, MO 64111-5939
(816) 931-1883
(816) 756-3645
Mailing address
901 E 104TH ST, MAILSTOP, KANSAS CITY, MO 64131
(816) 502-7117
(816) 932-9670
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
124617
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100392180A
—
KS
05
—
100392180C
—
KS
05
—
100392180D
—
KS
01
—
P00836076
RAILROAD MEDICARE
MO
01
—
P00842703
RAILROAD MEDICARE
KS
Enumeration date
06/01/2006
Last updated
11/07/2017
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