Provider Demographics
NPI:1922059484
Name:ADRIAN, SUE A (NP)
Entity Type:Individual
Prefix:MRS
First Name:SUE
Middle Name:A
Last Name:ADRIAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14413 WINDSOR ST
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66224-3669
Mailing Address - Country:US
Mailing Address - Phone:913-851-8252
Mailing Address - Fax:
Practice Address - Street 1:1132 SW 40 HWY
Practice Address - Street 2:
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64015-4610
Practice Address - Country:US
Practice Address - Phone:816-228-4400
Practice Address - Fax:816-228-9129
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO050331363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health