Provider Demographics
NPI:1124151246
Name:METCALF-WILSON, KRISTIN (RN, WHNP)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:METCALF-WILSON
Suffix:
Gender:F
Credentials:RN, WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4401 W 109TH ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1303
Mailing Address - Country:US
Mailing Address - Phone:913-312-5100
Mailing Address - Fax:
Practice Address - Street 1:711 N PROVIDENCE RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-4357
Practice Address - Country:US
Practice Address - Phone:573-443-0427
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO147494363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health