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Individual

NICOLE MARIE FEARING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
5701 W 119TH ST, SUITE 320, OVERLAND PARK, KS 66209-3721
(913) 345-6960
(913) 345-6966
Mailing address
5419 PAWNEE LN, FAIRWAY, KS 66205-2738
(816) 482-6378

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
0428286
KS
208600000X
Surgery Physician
2005029304
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
207546300
MO
01
722636
HEALTHLINK
MO
Enumeration date
05/15/2006
Last updated
01/27/2022
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