Provider Demographics
NPI:1164946976
Name:CORPUZ, SARA MELISSA (APRN, NNP-BC)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:MELISSA
Last Name:CORPUZ
Suffix:
Gender:F
Credentials:APRN, NNP-BC
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2401 GILLHAM RD.
Mailing Address - Street 2:PROVIDER ENROLLMENT
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64108-4619
Mailing Address - Country:US
Mailing Address - Phone:816-701-5200
Mailing Address - Fax:
Practice Address - Street 1:2401 GILLHAM RD
Practice Address - Street 2:NEONATOLOGY
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64108-4619
Practice Address - Country:US
Practice Address - Phone:816-234-3591
Practice Address - Fax:816-234-3590
Is Sole Proprietor?:No
Enumeration Date:2017-08-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS53-77792-041363LN0000X
MO2017024382363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal