Provider Demographics
NPI:1891431714
Name:LOCKHART, AMANDA KATE (APRN)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:KATE
Last Name:LOCKHART
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13643 HOLMES RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64145-1482
Mailing Address - Country:US
Mailing Address - Phone:816-599-7382
Mailing Address - Fax:
Practice Address - Street 1:4911 S ARROWHEAD DR STE 200
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055-7008
Practice Address - Country:US
Practice Address - Phone:816-503-3700
Practice Address - Fax:816-503-3704
Is Sole Proprietor?:No
Enumeration Date:2022-05-12
Last Update Date:2024-10-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2022015431363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily