Provider Demographics
NPI:1538604939
Name:LATHROP, MYRA FINIECE (MS, APRN, BC)
Entity type:Individual
Prefix:MRS
First Name:MYRA
Middle Name:FINIECE
Last Name:LATHROP
Suffix:
Gender:F
Credentials:MS, APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8314 NW 82ND ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64152
Mailing Address - Country:US
Mailing Address - Phone:708-834-4451
Mailing Address - Fax:
Practice Address - Street 1:3200 STRONG AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66106-2116
Practice Address - Country:US
Practice Address - Phone:913-262-0550
Practice Address - Fax:913-831-3048
Is Sole Proprietor?:No
Enumeration Date:2016-12-21
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016037547363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner