Provider Demographics
NPI:1861186421
Name:MAWEU, STEPHEN MUISYO
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:MUISYO
Last Name:MAWEU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 34
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:MO
Mailing Address - Zip Code:64012-0034
Mailing Address - Country:US
Mailing Address - Phone:913-626-1307
Mailing Address - Fax:
Practice Address - Street 1:13830 SANTAFE TRAIL DRIVE
Practice Address - Street 2:SUITE # 109
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66215
Practice Address - Country:US
Practice Address - Phone:913-626-1307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-06
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023011241363LP0808X
KS53-82284-012363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health