Provider Demographics
NPI:1477221778
Name:WEBER, LOGAN (DNP, FNP-C)
Entity Type:Individual
Prefix:
First Name:LOGAN
Middle Name:
Last Name:WEBER
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:LOGAN
Other - Middle Name:
Other - Last Name:RAYMOND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15954 W 171ST TER
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-7546
Mailing Address - Country:US
Mailing Address - Phone:402-310-7388
Mailing Address - Fax:
Practice Address - Street 1:19600 E 39TH ST S
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64057-2301
Practice Address - Country:US
Practice Address - Phone:816-698-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-01
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018001491163W00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse