Provider Demographics
NPI:1376397331
Name:MATHI, BIANCA CELIA (FNP-C)
Entity Type:Individual
Prefix:
First Name:BIANCA
Middle Name:CELIA
Last Name:MATHI
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 WILDFLOWER CIR
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:MO
Mailing Address - Zip Code:64060-8983
Mailing Address - Country:US
Mailing Address - Phone:816-929-1941
Mailing Address - Fax:913-588-6708
Practice Address - Street 1:13101 STATE LINE RD # 5724
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64145-1650
Practice Address - Country:US
Practice Address - Phone:816-942-2438
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-16
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-82989-041363LF0000X
MO2024004876363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily