Individual
MRS. KRISHELLE IVORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8350 N CHURCH RD, KANSAS CITY, MO 64158-1104
(913) 297-7472
(816) 407-9053
Mailing address
8350 N CHURCH RD, KANSAS CITY, MO 64158-1104
(913) 297-7472
(816) 407-9053
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0233929
MO
363LF0000X
Family Nurse Practitioner
2019000926
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0233929
—
MO
Enumeration date
11/20/2018
Last updated
05/12/2020
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