Individual
ANDREA LYNN NOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 234-3000
(816) 302-9939
Mailing address
2401 GILLHAM RD, PROVIDER ENROLLMENT DEPT, KANSAS CITY, MO 64108-4619
(816) 701-5200
(816) 302-9939
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Q7092
TX
207QA0000X
Adolescent Medicine (Family Medicine) Physician
Primary
2018026842
MO
2080A0000X
Pediatric Adolescent Medicine Physician
04-41282
KS
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
2018026842
MO
Other
Enumeration date
04/18/2014
Last updated
03/14/2026
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