Provider Demographics
NPI:1194164152
Name:BLACK, ADRIANNE JEAN (APRN)
Entity type:Individual
Prefix:
First Name:ADRIANNE
Middle Name:JEAN
Last Name:BLACK
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ADRIANNE
Other - Middle Name:JEAN
Other - Last Name:POSTLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4908 HALSEY ST
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66216-2030
Mailing Address - Country:US
Mailing Address - Phone:913-206-2383
Mailing Address - Fax:816-855-1909
Practice Address - Street 1:2401 GILLHAM RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64108-4619
Practice Address - Country:US
Practice Address - Phone:816-234-3000
Practice Address - Fax:816-855-1909
Is Sole Proprietor?:No
Enumeration Date:2013-06-22
Last Update Date:2017-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013031759363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal