Provider Demographics
NPI:1952676868
Name:STUIT, DENISE JILL (RN)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:JILL
Last Name:STUIT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:JILL
Other - Last Name:VREUGDENHIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2301 HOLMES ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64108-2640
Mailing Address - Country:US
Mailing Address - Phone:816-404-3744
Mailing Address - Fax:
Practice Address - Street 1:2301 HOLMES ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64108-2640
Practice Address - Country:US
Practice Address - Phone:816-404-1127
Practice Address - Fax:816-404-1103
Is Sole Proprietor?:No
Enumeration Date:2012-03-12
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA117122390200000X
MO2014024604367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO910015560Medicaid