Basic Information
| Provider Information | |||||||||
| NPI: | 1023396314 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MENGHINI | ||||||||
| FirstName: | ADRIENNE | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | C.P.N.P. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1501 NW JEFFERSON ST STE 304 | ||||||||
| Address2: | |||||||||
| City: | BLUE SPRINGS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 640157242 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8162241740 | ||||||||
| FaxNumber: | 8162241364 | ||||||||
| Practice Location | |||||||||
| Address1: | 1501 NW JEFFERSON ST | ||||||||
| Address2: | |||||||||
| City: | BLUE SPRINGS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 640157242 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8162284770 | ||||||||
| FaxNumber: | 8162281156 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/03/2011 | ||||||||
| LastUpdateDate: | 10/09/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 2018035609 | MO | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LP0200X | 2011022946 | MO | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics |
No ID Information.