Basic Information
Provider Information
NPI: 1871262667
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ZROSTLIK
FirstName: LAUREN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MSN, FNP-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: HARRELL
OtherFirstName: LAUREN
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 7900 LEES SUMMIT RD
Address2:  
City: KANSAS CITY
State: MO
PostalCode: 641391236
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 2301 HOLMES ST
Address2:  
City: KANSAS CITY
State: MO
PostalCode: 641082677
CountryCode: US
TelephoneNumber: 8164043995
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/07/2021
LastUpdateDate: 12/15/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/15/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X2021034594MOY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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