Provider Demographics
NPI:1740589142
Name:BRISENO, SUSANN M (NP)
Entity Type:Individual
Prefix:
First Name:SUSANN
Middle Name:M
Last Name:BRISENO
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:901 E 104TH ST
Mailing Address - Street 2:STE 200
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-4517
Mailing Address - Country:US
Mailing Address - Phone:913-541-3340
Mailing Address - Fax:913-492-7857
Practice Address - Street 1:10601 QUIVIRA RD
Practice Address - Street 2:STE 200
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66215-2310
Practice Address - Country:US
Practice Address - Phone:913-541-3340
Practice Address - Fax:913-492-7857
Is Sole Proprietor?:No
Enumeration Date:2011-03-24
Last Update Date:2016-03-23
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Provider Licenses
StateLicense IDTaxonomies
KS2011002166363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner