Provider Demographics
NPI:1194912766
Name:LANDRETH, URSULA SOFIA (APN/FNP)
Entity type:Individual
Prefix:MS
First Name:URSULA
Middle Name:SOFIA
Last Name:LANDRETH
Suffix:
Gender:F
Credentials:APN/FNP
Other - Prefix:
Other - First Name:URSULA
Other - Middle Name:SOFIA
Other - Last Name:MOSER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN/FNP
Mailing Address - Street 1:5405 W 151ST ST
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66224-8700
Mailing Address - Country:US
Mailing Address - Phone:913-202-3976
Mailing Address - Fax:
Practice Address - Street 1:8501 W 95TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-3220
Practice Address - Country:US
Practice Address - Phone:913-323-8880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-27
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012024327363LF0000X
KS75654363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily