DAXTEN PRUTER (NPI# 1053866541) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053866541 |
| Entity Type | Individual |
| Full Name | DAXTEN PRUTER |
| Credential | NURSE PRACTITIONER |
| Practice Address |
4251 Northern Ave Kansas City MO 64133-1593 |
| Mailing Address |
1767 N Sunset St Olathe KS 66061-7108 |
| Practice Telephone | 1816861470 |
| Mailing Telephone | 4054344691 |
| Enumeration Date | 2016-08-24 |
| Last Update Date | 2019-12-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 0121556 | OK | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
53-79163-032 | KS | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 13 Hillcrest Dr, Ponca City, OK 746044808 | 5807623456 | 5807629600 |
| Street Address |
4251 NORTHERN AVE |
| City | KANSAS CITY |
| State | MO |
| Zip Code | 64133-1593 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912989138 | Dane K Wicks | Family Medicine | 4251 Northern Ave, Honor Annex Kansas City Va, Kansas City, MO 64133 | 2005-11-15 |
| 1568063246 | Veronica Otero Ramos | Psychologist | 4251 Northern Ave, Kansas City, MO 64133-1593 | 2020-11-08 |
| 1053957472 | Avonne Danell Rosario | Nurse Practitioner | 4251 Northern Ave, Kansas City, MO 64133-1593 | 2019-11-20 |
| 1760860514 | Michael J. Redd | Marriage & Family Therapist | 4251 Northern Ave, Kansas City, MO 64133-1593 | 2015-05-13 |
| 1669859898 | Jeana Urania Smith | Social Worker | 4251 Northern Ave, Kansas City, MO 64133-1593 | 2015-04-27 |
| 1629486287 | Amber Hinton-dampf | Psychologist | 4251 Northern Ave, Kansas City, MO 64133-1593 | 2014-07-28 |
| 1215981980 | Savitri Manda | Family Medicine | 4251 Northern Ave, Kansas City, MO 64133-1593 | 2006-05-19 |
| 1235194705 | Sudhir Hegde | Internal Medicine | 4251 Northern Ave, Kansas City, MO 64133-1593 | 2006-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376029652 | Lauren Chapman Bauer | Occupational Therapy Assistant | 9540 E 75th Street, Raytown, MO 64133 | 2018-07-19 |
| 1871946160 | Brent Jordan Miller | Nurse Practitioner | 9400 East 350 Highway, Raytown, MO 64133 | 2016-07-21 |
| 1518355957 | Sheeba Fazili | Counselor | 8801 East, 63 Rd Street, Raytown, Suite 101, Missouri, KS 64133 | 2015-01-08 |
| 1770998676 | Diana Garcia | Speech-Language Pathologist | 11812 E. 61st. Street, Kansas City, MO 64133 | 2014-06-30 |
| 1326489642 | Helping Hands Adult Day Center | Clinic/Center | 6610 Blue Ridge Blvd., Kansas City, MO 64133 | 2013-07-15 |
| 1346687936 | Judith Hope Evans | Pharmacist | 300 Blue Parkway, Lees Summit, MO 64133 | 2013-05-23 |
| 1912249855 | Shanna O'brien | Social Worker | 8801 E 63rd St Ste 101, Raytown, MO 64133 | 2013-03-18 |
| 1013266550 | Lauren Sword | Chiropractor | 9537 E 57th Terr, Raytown, MO 64133 | 2012-08-30 |
| 1528339207 | Olivia Luelf | Speech-Language Pathologist | 6608 Raytown Rd., Raytown, MO 64133 | 2012-01-26 |
| 1356639074 | Michelle Paulette Cruickshank | Massage Therapist | 6522 Sterling Ave, Raytown, MO 64133 | 2011-07-15 |
| Find all providers in zip 64133 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467051680 | Debra Kim Lietzke | Nurse Practitioner | 4900 N 126th St, Kansas City, KS 66109-5121 | 2020-10-19 |
| 1487252193 | Julie O'gara | Nurse Practitioner | 9709 Nw 72nd Ter, Kansas City, MO 64152-1813 | 2020-10-14 |
| 1144836313 | Corinne Lee Nilsen | Nurse Practitioner | 3939 Holmes St, Kansas City, MO 64110-1123 | 2020-09-22 |
| 1821604430 | Nathan D Burditt | Nurse Practitioner | 5917 Mcgee St, Kansas City, MO 64113-2205 | 2020-09-18 |
| 1760094577 | Diana Michelle Hiestand | Nurse Practitioner | 250 W 2nd St Apt 4101, Kansas City, MO 64105-2181 | 2020-08-21 |
| 1093324816 | Claire Sorensen | Nurse Practitioner | 427 E 63rd Ter, Kansas City, MO 64110-3333 | 2020-07-28 |
| 1003434705 | Kristin A Meyer | Nurse Practitioner | 700 W 31st St Ste 706, Kansas City, MO 64108-3628 | 2020-07-08 |
| 1023634599 | Sibree L Vickers | Nurse Practitioner | 3627 Ne 85th St, Kansas City, MO 64156-1309 | 2020-06-22 |
| 1457975625 | Jazmine Ayana Spencer | Nurse Practitioner | 800 E 101st Ter Ste 240, Kansas City, MO 64131-5300 | 2020-06-03 |
| 1841813706 | Kristine Elizabeth Silcott | Nurse Practitioner | 5239 N Flora Ave, Kansas City, MO 64118-5720 | 2020-05-26 |
| Find all providers in KANSAS CITY | ||||
| City | KANSAS CITY |
| Zip Code | 64133 |
Please comment or provide details below to improve the information on DAXTEN PRUTER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.