Individual
MS. ROCHE' BURRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
5221 PROSPECT AVE, KANSAS CITY, MO 64130
(913) 250-9746
Mailing address
5221 PROSPECT AVE, KANSAS CITY, MO 64130
(913) 250-9746
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2017028039
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2017028039
NURSING LICENSE
MO
Enumeration date
04/11/2019
Last updated
04/11/2019
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