Individual
LAKEISHA KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6119 N EVANS AVE, KANSAS CITY, MO 64151-2162
(816) 868-0788
Mailing address
6119 N EVANS AVE, KANSAS CITY, MO 64151-2162
(816) 868-0788
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2021016504
MO
Other
Enumeration date
09/27/2021
Last updated
09/27/2021
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