Individual
SARETA WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2701 E 31ST ST, KANSAS CITY, MO 64128-1516
(816) 384-0700
Mailing address
12101 E 62ND TER, KANSAS CITY, MO 64133-4461
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2006007310
MO
Other
Enumeration date
12/08/2015
Last updated
12/08/2015
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