Basic Information
| Provider Information | |||||||||
| NPI: | 1124332523 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCPHEETERS | ||||||||
| FirstName: | DAWN | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | RN,BSN,MSN,WHNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2310 HOLMES ST | ||||||||
| Address2: | STE 800 | ||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641082602 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8162182523 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7900 LEES SUMMIT RD | ||||||||
| Address2: | |||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641391236 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8164044862 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/28/2010 | ||||||||
| LastUpdateDate: | 03/14/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LW0102X | MO2010026199 | MO | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Women's Health |
ID Information
| ID | Type | State | Issuer | Description | 06215024 | 01 | MO | BLUE CROSS BLUE SHIELD OF KANSAS CITY | OTHER | 200282660A | 05 | KS | MEDICAID | 0110035 | 01 | KS | BLUE CROSS BLUE SHIELD OF KANSAS | OTHER | 100216210A | 05 | KS | MEDICAID | 4508144 | 01 | AETNA | OTHER | 03929191 | 01 | CIGNA | OTHER | 1535310 | 01 | UNITED HEALTHCARE | OTHER | 1679614838 | 05 | MO | MEDICAID | 4507780 | 01 | AETNA | OTHER |