Provider Demographics
NPI:1598292534
Name:KAM, MINHANH (FNP)
Entity Type:Individual
Prefix:
First Name:MINHANH
Middle Name:
Last Name:KAM
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:MINH-ANH
Other - Middle Name:
Other - Last Name:PHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:901 E 104TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-4517
Mailing Address - Country:US
Mailing Address - Phone:816-599-9499
Mailing Address - Fax:816-932-9670
Practice Address - Street 1:20 NE SAINT LUKES BLVD STE 350
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64086-6007
Practice Address - Country:US
Practice Address - Phone:816-347-4717
Practice Address - Fax:816-347-7466
Is Sole Proprietor?:No
Enumeration Date:2017-05-22
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS77712363LF0000X
MO2017012410363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2017012410OtherFAMILY/INDIVIDUAL ACROSS THE LIFESPAN
KS77712OtherSTATE LICENSE