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Individual

BRANDIE A NIEDENS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2800 CLAY EDWARDS DR, NORTH KANSAS CITY, MO 64116-3220
(816) 346-7220
(816) 346-7242
Mailing address
PO BOX 11157, KANSAS CITY, MO 64119-0157
(913) 234-1350
(913) 234-1108

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2003015172
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
209171206
MO
01
33194045
BCBS KC MO
01
P00446293
RR MEDICARE GROUP CD1534
Enumeration date
03/09/2006
Last updated
07/19/2013
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