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Individual

STEPHANIE LYNN O'TOOLE

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) 234-3000
(816) 302-9939
Mailing address
2401 GILLHAM RD, PROVIDER ENROLLMENT, KANSAS CITY, MO 64108-4619
(816) 701-5200
(816) 302-9939

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2014005153
MO
363LF0000X
Family Nurse Practitioner
53-76261-032
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100098080A
KS
01
100098080C
SEDWAIVER
KS
Enumeration date
02/10/2014
Last updated
09/25/2017
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