Provider Demographics
NPI:1073959979
Name:SIEBERT, METTA KATHERINE (NP)
Entity Type:Individual
Prefix:
First Name:METTA
Middle Name:KATHERINE
Last Name:SIEBERT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:METTA
Other - Middle Name:KATHERINE
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:2401 GILLHAM RD.
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64108
Mailing Address - Country:US
Mailing Address - Phone:816-760-5560
Mailing Address - Fax:816-302-9987
Practice Address - Street 1:2401 GILLHAM RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64108
Practice Address - Country:US
Practice Address - Phone:816-760-5560
Practice Address - Fax:816-302-9987
Is Sole Proprietor?:No
Enumeration Date:2013-05-17
Last Update Date:2019-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013021884363LP0222X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0222XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics, Critical Care