Provider Demographics
NPI:1497570642
Name:WUNDER INTEGRATIVE HEALTH AND WELLNESS LLC
Entity type:Organization
Organization Name:WUNDER INTEGRATIVE HEALTH AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:WUNDER
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:402-216-8249
Mailing Address - Street 1:4049 PENNSYLVANIA AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-3022
Mailing Address - Country:US
Mailing Address - Phone:816-667-6587
Mailing Address - Fax:816-379-3754
Practice Address - Street 1:135 OAK ST
Practice Address - Street 2:
Practice Address - City:BONNER SPRINGS
Practice Address - State:KS
Practice Address - Zip Code:66012-1026
Practice Address - Country:US
Practice Address - Phone:816-667-6597
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty