Provider Demographics
NPI:1407853484
Name:EHRICH, REBECCA C (NP APRN BC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:C
Last Name:EHRICH
Suffix:
Gender:F
Credentials:NP APRN BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5400 N OAK TRFY
Mailing Address - Street 2:STE 200
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64118-4688
Mailing Address - Country:US
Mailing Address - Phone:816-453-0900
Mailing Address - Fax:816-453-6271
Practice Address - Street 1:5400 N OAK TRFY
Practice Address - Street 2:STE 200
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64118-4688
Practice Address - Country:US
Practice Address - Phone:816-453-0900
Practice Address - Fax:816-453-6271
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO148089363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
S51173Medicare UPIN
MOMA3392003Medicare PIN