Individual
MINDY E ELDRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 983-6473
Mailing address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 983-6473
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
14-97699-042
KS
363LF0000X
Family Nurse Practitioner
Primary
2003018837
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14-97699-042
KS LIC#
KS
01
—
2003018837
MO
MO
Enumeration date
10/19/2007
Last updated
02/22/2021
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