Individual
MRS. ELIZABETH ANN HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
3201 FAIRFAX TRFY, KANSAS CITY, KS 66115-1307
(913) 573-7053
(913) 573-7001
Mailing address
12103 STATE ROUTE 7, LAKE LOTAWANA, MO 64086-9165
(816) 853-3077
(913) 573-7001
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
2011017381
MO
363LF0000X
Family Nurse Practitioner
Primary
53-75912-101
KS
363LX0106X
Occupational Health Nurse Practitioner
53-75912-101
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1629362645
—
MO
05
—
200877280C
—
KS
Enumeration date
06/07/2011
Last updated
08/25/2023
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