Provider Demographics
NPI:1285068684
Name:MUSGROVE, CHRISTINE ANN (APRN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:ANN
Last Name:MUSGROVE
Suffix:
Gender:F
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21350 W 153RD ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-5413
Mailing Address - Country:US
Mailing Address - Phone:913-322-4950
Mailing Address - Fax:
Practice Address - Street 1:4300 BRENNER DR
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66104-1163
Practice Address - Country:US
Practice Address - Phone:913-334-0294
Practice Address - Fax:913-825-6481
Is Sole Proprietor?:No
Enumeration Date:2013-08-21
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-76016-041363LF0000X
KS76016363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily