Provider Demographics
NPI:1235551771
Name:VAN TASELL, JULIE G (FNP-C)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:G
Last Name:VAN TASELL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:G
Other - Last Name:TAPP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9151 NE 81ST TER STE 105
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64158-1176
Mailing Address - Country:US
Mailing Address - Phone:816-994-8787
Mailing Address - Fax:816-994-8788
Practice Address - Street 1:9151 NE 81ST TER STE 105
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64158-1176
Practice Address - Country:US
Practice Address - Phone:816-994-8787
Practice Address - Fax:816-994-8788
Is Sole Proprietor?:No
Enumeration Date:2014-01-17
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014000714363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO154552OtherMO LICENSE