Provider Demographics
NPI: | 1619680527 |
---|---|
Name: | MATUREY, ALARYCE (CPNP-PC) |
Entity Type: | Individual |
Prefix: | |
First Name: | ALARYCE |
Middle Name: | |
Last Name: | MATUREY |
Suffix: | |
Gender: | F |
Credentials: | CPNP-PC |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 19935 W 117TH TER |
Mailing Address - Street 2: | |
Mailing Address - City: | OLATHE |
Mailing Address - State: | KS |
Mailing Address - Zip Code: | 66061-8715 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 913-940-0852 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 2401 GILLHAM RD |
Practice Address - Street 2: | |
Practice Address - City: | KANSAS CITY |
Practice Address - State: | MO |
Practice Address - Zip Code: | 64108-4619 |
Practice Address - Country: | US |
Practice Address - Phone: | 816-234-3000 |
Practice Address - Fax: | 816-302-9939 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2023-01-05 |
Last Update Date: | 2023-05-04 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
KS | 13-131743-122 | 163W00000X |
KS | 53-81854-122 | 363LP2300X |
MO | 2023008358 | 363LP0200X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 363LP0200X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics |
No | 163W00000X | Nursing Service Providers | Registered Nurse | |
No | 363LP2300X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Primary Care |