Individual
EUNICE MINOO MUTISYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
9406 E 63RD ST, RAYTOWN, MO 64133-4904
(816) 356-1000
Mailing address
9406 E 63RD ST, RAYTOWN, MO 64133-4904
(816) 356-1000
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2019024712
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
420074076
—
MO
Enumeration date
07/09/2019
Last updated
11/25/2020
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