Provider Demographics
NPI:1306826383
Name:DEAN, EVELYN I (RN, ACNS-BC)
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:I
Last Name:DEAN
Suffix:
Gender:F
Credentials:RN, ACNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4330 WORNALL RD
Mailing Address - Street 2:SUITE 2000
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-3201
Mailing Address - Country:US
Mailing Address - Phone:816-931-1883
Mailing Address - Fax:816-931-0422
Practice Address - Street 1:4330 WORNALL RD
Practice Address - Street 2:SUITE 2000
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-3201
Practice Address - Country:US
Practice Address - Phone:816-931-1883
Practice Address - Fax:816-931-0422
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO104464364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO427214804Medicaid
F06A936BMedicare ID - Type Unspecified