Provider Demographics
NPI:1053583088
Name:AUSTIN, OBIE ANDREL (MSN,ANP-BC)
Entity type:Individual
Prefix:MR
First Name:OBIE
Middle Name:ANDREL
Last Name:AUSTIN
Suffix:
Gender:M
Credentials:MSN,ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2464 CHARLOTTE ST
Mailing Address - Street 2:HEALTH SCEINCES BUILDING
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64108-2718
Mailing Address - Country:US
Mailing Address - Phone:816-235-5609
Mailing Address - Fax:816-235-1701
Practice Address - Street 1:4825 TROOST AVE
Practice Address - Street 2:SUITE 115
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64110-2030
Practice Address - Country:US
Practice Address - Phone:816-235-6133
Practice Address - Fax:816-235-6565
Is Sole Proprietor?:No
Enumeration Date:2008-03-31
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MORN140639363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health