Provider Demographics
NPI:1912764085
Name:VENTRESCA, ALLICIA R (FNP-C)
Entity type:Individual
Prefix:
First Name:ALLICIA
Middle Name:R
Last Name:VENTRESCA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:ALLI
Other - Middle Name:
Other - Last Name:VENTRESCA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 749495
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-9495
Mailing Address - Country:US
Mailing Address - Phone:855-963-2100
Mailing Address - Fax:813-321-1296
Practice Address - Street 1:2316 E MEYER BLVD
Practice Address - Street 2:1 EAST
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64132-1136
Practice Address - Country:US
Practice Address - Phone:816-974-5050
Practice Address - Fax:816-683-7645
Is Sole Proprietor?:No
Enumeration Date:2024-03-04
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024005882363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily