Individual
IMMACULATE KUME NGUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
8219 E 85TH TER, RAYTOWN, MO 64138-3020
(816) 204-1334
Mailing address
8219 E 85TH TER, RAYTOWN, MO 64138-3020
(816) 204-1334
Taxonomy
Speciality
Code
Description
License number
State
163WG0600X
Gerontology Registered Nurse
23541795
MO
363L00000X
Nurse Practitioner
Primary
80845
KS
Other
Enumeration date
03/24/2020
Last updated
12/04/2024
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