Willie Dewrena Person, RN
Individual provider Active NPI Registered Nurse · KC, MO
NPI 1720163280 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1720163280
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 090891 (MO)
- Practice address
- 6801 E 117TH St
KC, MO 64134 - Phone
- (816) 554-5519
- Fax
- (816) 554-5550
- NPI assigned
- Oct 25, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 090891 | MO | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 090891 | MO | Yes |
Addresses
Primary practice location
6801 E 117TH St
KC, MO 64134
Mailing address
6801 E 117TH St
KC, MO 64134
Phone (816) 554-5519
Other providers in KC, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.