Individual
MIKALA MARIE LODDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AG-ACNP
Contact information
Practice address
8700 N GREEN HILLS RD, KANSAS CITY, MO 64154-1910
(913) 574-2520
(913) 574-2612
Mailing address
9200 INDIAN CREEK PKWY STE 300, OVERLAND PARK, KS 66210-2008
(913) 574-2800
(913) 574-2336
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
2017016078
MO
363LA2100X
Acute Care Nurse Practitioner
53-77352-121
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811443070
—
MO
05
—
201154160B
—
KS
Enumeration date
08/28/2016
Last updated
07/21/2022
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