Individual
MS. STACEY VANDERPOOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4401 WORNALL RD, KANSAS CITY, MO 64111-3220
(816) 932-2000
Mailing address
901 E 104TH ST, MS 400N, KANSAS CITY, MO 64131
(816) 502-8752
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2017024366
MO
Other
Enumeration date
03/06/2017
Last updated
05/10/2022
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