Individual
DEXTER ALLEN WALSH-WIGGINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
556 WESTPORT RD, KANSAS CITY, MO 64111-3014
(815) 303-9000
Mailing address
556 WESTPORT RD, KANSAS CITY, MO 64111-3014
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2019002355
MO
363L00000X
Nurse Practitioner
Primary
53-82285-011
KS
Other
Enumeration date
04/25/2022
Last updated
04/01/2024
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