Individual
MR. EARL MAYBERRY III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
2205 W 36TH AVE, KANSAS CITY, KS 66103-2107
(913) 956-5620
Mailing address
2205 W 36TH AVE, KANSAS CITY, KS 66103-2107
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
13-75191
KS
Other
Enumeration date
05/14/2015
Last updated
05/14/2015
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