Provider Demographics
NPI:1770649691
Name:DIPASQUALE, MEREDITH ANNE (APRN, BC)
Entity type:Individual
Prefix:MRS
First Name:MEREDITH
Middle Name:ANNE
Last Name:DIPASQUALE
Suffix:
Gender:F
Credentials:APRN, BC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:9411 N OAK TRFY
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64155-2233
Mailing Address - Country:US
Mailing Address - Phone:816-436-7072
Mailing Address - Fax:816-436-2743
Practice Address - Street 1:2790 CLAY EDWARDS DR
Practice Address - Street 2:SUITE 300
Practice Address - City:NORTH KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-3276
Practice Address - Country:US
Practice Address - Phone:816-221-6750
Practice Address - Fax:816-221-7280
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006011272363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOR08000005Medicare PIN