Provider Demographics
NPI:1952066672
Name:MCCLANAHAN, EMILY ROSE (APRN)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:ROSE
Last Name:MCCLANAHAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:110 NE SAINT LUKES BLVD STE 530
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64086-6075
Mailing Address - Country:US
Mailing Address - Phone:816-554-3838
Mailing Address - Fax:816-524-5110
Practice Address - Street 1:110 NE SAINT LUKES BLVD STE 530
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64086-6075
Practice Address - Country:US
Practice Address - Phone:816-554-3838
Practice Address - Fax:816-524-5110
Is Sole Proprietor?:No
Enumeration Date:2021-11-08
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021044944363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily