Provider Demographics
NPI:1972895324
Name:MIDWIVES OF KANSAS CITY WOMEN'S CENTER
Entity Type:Organization
Organization Name:MIDWIVES OF KANSAS CITY WOMEN'S CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:RYAN
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, CNM
Authorized Official - Phone:913-547-1495
Mailing Address - Street 1:6115 NIEMAN RD
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66203-2939
Mailing Address - Country:US
Mailing Address - Phone:877-551-0001
Mailing Address - Fax:866-885-9694
Practice Address - Street 1:6115 NIEMAN RD
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66203-2939
Practice Address - Country:US
Practice Address - Phone:877-551-0001
Practice Address - Fax:866-885-9694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-04
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO259263523Medicaid
KS200331250BMedicaid