Provider Demographics
NPI:1750339677
Name:BEAR, LORA ANN (RN MSN CPNP)
Entity type:Individual
Prefix:MRS
First Name:LORA
Middle Name:ANN
Last Name:BEAR
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Gender:F
Credentials:RN MSN CPNP
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Mailing Address - Street 1:2401 GILLHAM RD
Mailing Address - Street 2:PROVIDER ENROLLMENT
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64108-4619
Mailing Address - Country:US
Mailing Address - Phone:816-701-5200
Mailing Address - Fax:816-302-9939
Practice Address - Street 1:2401 GILLHAM RD
Practice Address - Street 2:NEPHROLOGY
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64108
Practice Address - Country:US
Practice Address - Phone:816-234-3030
Practice Address - Fax:816-802-1244
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2018-08-15
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Provider Licenses
StateLicense IDTaxonomies
MO121057363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200310010AMedicaid
MS427184205Medicaid
MS427184205Medicaid
KS200310010AMedicaid