Individual
MISS MADISON BREANNE NIGUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5844 NW BARRY RD STE 120, KANSAS CITY, MO 64154-1483
(816) 472-9595
(816) 472-1132
Mailing address
901 E 104TH ST, MAILSTOP 400, KANSAS CITY, MO 64131-4517
(816) 599-9499
(816) 932-9670
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2020039368
MO
Other
Enumeration date
05/28/2020
Last updated
05/24/2021
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