Individual
SAGE NICOLAUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
500 NE BARRY RD, KANSAS CITY, MO 64155-2879
(816) 521-5792
(816) 251-5791
Mailing address
7706 NE 103RD ST, KANSAS CITY, MO 64157-8069
(816) 442-5292
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2019009056
MO
363L00000X
Nurse Practitioner
Primary
2025042803
MO
363L00000X
Nurse Practitioner
53-84890-081
KS
Other
Enumeration date
01/16/2026
Last updated
01/16/2026
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