Provider Demographics
NPI:1982438354
Name:PRZEKURAT, GRACE C (FNP)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:C
Last Name:PRZEKURAT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8550 MARSHALL DR STE 220
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66214-9836
Mailing Address - Country:US
Mailing Address - Phone:816-524-3799
Mailing Address - Fax:
Practice Address - Street 1:615 SW 3RD ST
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64063-2212
Practice Address - Country:US
Practice Address - Phone:816-524-3799
Practice Address - Fax:913-495-3727
Is Sole Proprietor?:No
Enumeration Date:2024-08-28
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14159562101163W00000X
MO2024037870363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse