Individual
BRIANNE RENEE ROCKEFELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4000 CAMBRIDGE ST, KANSAS CITY, KS 66160-1353
(913) 588-6000
Mailing address
4000 CAMBRIDGE ST, KANSAS CITY, KS 66160-8501
(913) 588-6000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15-01830
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
068002340
MEDICARE PTAN
KS
05
—
201119330A
—
KS
Enumeration date
08/17/2015
Last updated
06/30/2021
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