Provider Demographics
NPI:1104863810
Name:MENEFEE, FELICIA D (RN, BC, FNP, ACNS-BC)
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:D
Last Name:MENEFEE
Suffix:
Gender:F
Credentials:RN, BC, FNP, ACNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 E 104TH ST
Mailing Address - Street 2:MAILSTOP 400S
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131
Mailing Address - Country:US
Mailing Address - Phone:816-502-7117
Mailing Address - Fax:816-932-9670
Practice Address - Street 1:12330 METCALF AVE STE 280
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213-1302
Practice Address - Country:US
Practice Address - Phone:816-931-1883
Practice Address - Fax:816-751-8635
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO129258363LA2200X, 364SM0705X, 363L00000X
KS5374713364S00000X, 364SM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
No364SM0705XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistMedical-Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100340280DMedicaid
MO424628501Medicaid
KS100340280AMedicaid
KS100340280CMedicaid
MOP00836073OtherRAILROAD MEDICARE
MOMA2491015Medicare PIN
S82404Medicare UPIN
MO424628501Medicaid
MOMA2492015Medicare PIN
KSKA1724050Medicare PIN