Provider Demographics
NPI:1386459402
Name:ROBERTSON, LURE'A DANIELLE (RN)
Entity type:Individual
Prefix:MS
First Name:LURE'A
Middle Name:DANIELLE
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1406 WALKER AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66104-5921
Mailing Address - Country:US
Mailing Address - Phone:816-359-0173
Mailing Address - Fax:
Practice Address - Street 1:1406 WALKER AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66104-5921
Practice Address - Country:US
Practice Address - Phone:816-359-0173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-07
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA232319163W00000X
KS13144098072163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse