Provider Demographics
NPI:1760980866
Name:URIBE, MOLLY TRUAX (NP-C)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:TRUAX
Last Name:URIBE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4603 NE 83RD TER
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64119-7618
Mailing Address - Country:US
Mailing Address - Phone:501-410-3722
Mailing Address - Fax:
Practice Address - Street 1:1202 N 38TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66102-2229
Practice Address - Country:US
Practice Address - Phone:913-777-7600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-24
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS78072363L00000X
MO2018031876363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner