Provider Demographics
NPI:1801117452
Name:POINTER, STEPHANIE L (RN, FNP-C)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:L
Last Name:POINTER
Suffix:
Gender:F
Credentials:RN, FNP-C
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:L
Other - Last Name:HOLDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, FNP-C
Mailing Address - Street 1:2316 E MEYER BLVD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64132-1136
Mailing Address - Country:US
Mailing Address - Phone:816-276-4155
Mailing Address - Fax:
Practice Address - Street 1:2316 E MEYER BLVD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64132-1136
Practice Address - Country:US
Practice Address - Phone:816-217-4155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-17
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005020684363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily