Provider Demographics
NPI:1710043625
Name:ROTH, SHEILA RHEA (WHNP CNM)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:RHEA
Last Name:ROTH
Suffix:
Gender:F
Credentials:WHNP CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6400 PROSPECT AVE
Mailing Address - Street 2:# 598
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64132-4128
Mailing Address - Country:US
Mailing Address - Phone:816-444-6888
Mailing Address - Fax:816-444-1375
Practice Address - Street 1:6400 PROSPECT AVE
Practice Address - Street 2:# 598
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64132-4128
Practice Address - Country:US
Practice Address - Phone:816-444-6888
Practice Address - Fax:816-444-1375
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO095272363L00000X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Not Answered367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife