Individual
ELIZABETH ALLISON RUTH BERWALDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
2790 CLAY EDWARDS DR STE 520, NORTH KANSAS CITY, MO 64116-3274
(816) 221-6750
(816) 221-7280
Mailing address
9411 N. OAK TRAFFICWAY, LL1, KANSAS CITY, MO 64155-2144
(816) 691-1655
(913) 428-2951
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
2022046158
MO
363LF0000X
Family Nurse Practitioner
Primary
5378555072
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174504732
—
KS
Enumeration date
03/11/2019
Last updated
03/03/2023
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