Provider Demographics
NPI:1508756693
Name:RAMBO, DEJENET
Entity type:Individual
Prefix:
First Name:DEJENET
Middle Name:
Last Name:RAMBO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 WESTPORT RD UNIT 45002
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-9998
Mailing Address - Country:US
Mailing Address - Phone:816-876-0281
Mailing Address - Fax:
Practice Address - Street 1:1106 E 30TH ST STE M3
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64109-1507
Practice Address - Country:US
Practice Address - Phone:816-876-0281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-08
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherGroup - Single Specialty