Provider Demographics
NPI:1841651346
Name:TULLIS, LAURA L (ARNP)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:L
Last Name:TULLIS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:L
Other - Last Name:RUHNKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:1000 CARONDELET DR STE 201B
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-4673
Mailing Address - Country:US
Mailing Address - Phone:913-956-2250
Mailing Address - Fax:913-956-2251
Practice Address - Street 1:1000 CARONDELET DR STE 201B
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-4673
Practice Address - Country:US
Practice Address - Phone:913-956-2250
Practice Address - Fax:913-956-2251
Is Sole Proprietor?:No
Enumeration Date:2016-03-10
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS77214363LA2200X, 363LG0600X
MO2016009380363LA2200X, 363L00000X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner