1700310877 NPI number — AMBER NICOLE JOHNSON FNP

Table of content: ROBERT TYLER LEAVITT (NPI 1659954659)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700310877 NPI number — AMBER NICOLE JOHNSON FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JOHNSON
Provider First Name:
AMBER
Provider Middle Name:
NICOLE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
FNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1700310877
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/25/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5101 COLLEGE BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LEAWOOD
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66211-1614
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
816-478-4200
Provider Business Mailing Address Fax Number:
816-875-2598

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8919 PARALLEL PKWY STE 555
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66112-3628
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-596-3940
Provider Business Practice Location Address Fax Number:
913-596-3760
Provider Enumeration Date:
04/16/2017

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  201702240 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: 5377717082 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 163W00000X , with the licence number: 13102581082 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)