Provider Demographics
NPI:1336849553
Name:MOTWANI, PAIGE (FNP)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:MOTWANI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:64034-9108
Mailing Address - Country:US
Mailing Address - Phone:816-785-3543
Mailing Address - Fax:
Practice Address - Street 1:3521 NE RALPH POWELL RD
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64064-2337
Practice Address - Country:US
Practice Address - Phone:816-533-4398
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-07
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023017038363LF0000X
MOF02230649363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily