Provider Demographics
NPI:1891440608
Name:DUTHOO, KORTNIE (FNP-C)
Entity Type:Individual
Prefix:
First Name:KORTNIE
Middle Name:
Last Name:DUTHOO
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 PRAIRIE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:MO
Mailing Address - Zip Code:64060-7628
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1420 S 42ND ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66106-1952
Practice Address - Country:US
Practice Address - Phone:913-831-1100
Practice Address - Fax:913-831-0827
Is Sole Proprietor?:No
Enumeration Date:2022-02-21
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021035675363LF0000X
KS5380700021363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily