Individual provider Active NPI

Latrece Holloway, FNP

  • Family Nurse Practitioner
  • Independence, MO
National Provider Identifier
1770948234
Registry record updated Apr 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2016012516 Issued in MO
Practice address
19600 E 39TH St S
Independence, MO 64057-2301
Phone
(816) 462-7612
NPI assigned
Dec 28, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 2010038006 MO
Family Nurse Practitioner 363LF0000X 2016012516 MO Primary

Addresses

Primary practice location

19600 E 39TH St S
Independence, MO 64057-2301

Mailing address

3338 S Norwood Ave
Independence, MO 64052-2724
Phone (816) 462-7612

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160715000156 MO Practitioner - Nurse Practitioner 8729370515 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2010038006MOMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Services of Mo, LLC CurrentSince Apr 1, 2023 Accepting new patients

Locations

19600 E 39th St S
Independence, MO 64057
Phone (816) 698-7000

2316 E Meyer Blvd
Kansas City, MO 64132
Phone (816) 276-4360

2100 SE Blue Pkwy
Lees Summit, MO 64063
Phone (816) 282-5175

403 Burkarth Rd
Warrensburg, MO 64093
Phone (660) 474-2500

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1451260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776643200000",
    "number": "1770948234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3338 S NORWOOD AVE",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640522724",
            "telephone_number": "816-462-7612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19600 E 39TH ST S",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640572301",
            "telephone_number": "816-462-7612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLOWAY",
        "first_name": "LATRECE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-28",
        "last_updated": "2026-04-20",
        "certification_date": "2026-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2010038006",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2016012516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, MO

Sources for this page

Verify at the official NPI Registry.