Organization
WELLSPRING REGENERATIVE HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONY BREEN FNP (NURSE PRACTITIONER)
(816) 651-7813
Entity
Organization
Contact information
Practice address
13160 STATE LINE RD, LEAWOOD, KS 66209-1708
(816) 651-7813
Mailing address
12120 STATE LINE RD # 125, LEAWOOD, KS 66209-1254
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407567068
—
MO
05
—
1851823694
—
MO
Enumeration date
09/05/2024
Last updated
09/02/2025
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