Provider Demographics
NPI:1730261504
Name:MCGUIRE, KIRSTEN L (ARNP)
Entity type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:L
Last Name:MCGUIRE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5901 ALHAMBRA ST
Mailing Address - Street 2:
Mailing Address - City:FAIRWAY
Mailing Address - State:KS
Mailing Address - Zip Code:66205-3158
Mailing Address - Country:US
Mailing Address - Phone:816-506-5348
Mailing Address - Fax:
Practice Address - Street 1:115 EASTPARK DR
Practice Address - Street 2:SUITE 300
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-7548
Practice Address - Country:US
Practice Address - Phone:615-600-4029
Practice Address - Fax:615-600-4059
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-44936-111363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
1730261504OtherNPI
KSMM1583601OtherDEA
MOP15197Medicare UPIN