Individual
EDITH H RODERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 234-3970
(816) 983-6845
Mailing address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 234-3970
(816) 983-6845
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
090677
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4257576601
—
KS
05
—
425833803
—
MO
Enumeration date
04/26/2006
Last updated
07/08/2007
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