Provider Demographics
NPI:1053957472
Name:ROSARIO, AVONNE DANELL (NP)
Entity type:Individual
Prefix:
First Name:AVONNE
Middle Name:DANELL
Last Name:ROSARIO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14572 S GREENWOOD ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-9010
Mailing Address - Country:US
Mailing Address - Phone:816-876-8274
Mailing Address - Fax:
Practice Address - Street 1:4251 NORTHERN AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64133-1593
Practice Address - Country:US
Practice Address - Phone:816-922-2333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-20
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32217363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care