Individual
DIANA KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.P.N.P.
Contact information
Practice address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 234-3000
Mailing address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 234-3000
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
2001015331
MO
363LP0200X
Pediatric Nurse Practitioner
99224
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1861576464
—
MO
01
—
F29A00004
MEDICARE PTAN
—
Enumeration date
10/24/2006
Last updated
08/11/2015
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