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Organization
INTEGRATIVE HEALTH PROVIDERS LLC
Active
Organization
INTEGRATIVE HEALTH PROVIDERS LLC
Active
Other names
Vitality Lifestyle Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
EVERETT G. BENNETT III NP (OWNER)
(913) 353-4703
Entity
Organization
Contact information
Practice address
11001 HAUSER ST, LENEXA, KS 66210-3708
(913) 963-6618
(913) 353-4031
Mailing address
11001 HAUSER ST, LENEXA, KS 66210-3708
(913) 963-6618
(913) 353-4031
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
NULL
163W00000X
Registered Nurse
—
—
207R00000X
Internal Medicine Physician
04-23015
KS
363LA2200X
Adult Health Nurse Practitioner
Primary
—
NULL
363LA2200X
Adult Health Nurse Practitioner
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
06/06/2017
Last updated
08/08/2024
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