Moddrell, Melissa L

Moddrell, Melissa L is an individual health care provider with primary practice located at 4000 Cambridge St , Kansas City KS 66160-3197. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as her primary health care specialty. Moddrell, Melissa L can be contacted via phone (913) 588-5000.

Contact Information

Primary practice address
4000 Cambridge St Kansas City KS 66160-3197
Phone: (913) 588-5000
Fax: (312) 695-1903
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 085-002953 Illinois

Profile Details

NPI number 1376754044
LBN Legal business name Moddrell, Melissa L
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date May 24th, 2007
Last updated Apr 20th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376754044 NPPES
Illinois Other 085-002953 IL STATE LIC
Illinois Other 15-02370 IL STATE LIC

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