Provider Demographics
NPI:1285042457
Name:MCPEAK, LORA BETH (RN)
Entity Type:Individual
Prefix:MRS
First Name:LORA
Middle Name:BETH
Last Name:MCPEAK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:LORA
Other - Middle Name:BETH
Other - Last Name:EVANS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:515 W 46TH ST
Mailing Address - Street 2:APT. 10
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64112-1490
Mailing Address - Country:US
Mailing Address - Phone:816-591-6868
Mailing Address - Fax:
Practice Address - Street 1:4801 E LINWOOD BLVD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64128-2226
Practice Address - Country:US
Practice Address - Phone:816-861-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-31
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014022713163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse