Individual
BRENDA L. POLACHEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
4201 N BELT HWY, SAINT JOSEPH, MO 64506-1299
(816) 749-4444
(816) 749-4446
Mailing address
4201 N BELT HWY, SAINT JOSEPH, MO 64506-1299
(816) 749-4444
(816) 749-4446
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
134300
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447577820
—
MO
05
—
200658140A
—
KS
01
—
P00847182
RR MEDICARE
MO
Enumeration date
04/26/2010
Last updated
05/13/2011
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