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Individual

KELLY ANDRA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
10787 NALL AVE, SUITE 310, OVERLAND PARK, KS 66211-1375
(913) 945-6900
(913) 945-6970
Mailing address
10787 NALL AVE, SUITE 310, OVERLAND PARK, KS 66211-1375
(913) 945-6900
(913) 945-6970

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0438218
KS
207R00000X
Internal Medicine Physician
2007015074
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
205481609
MO
Enumeration date
05/01/2007
Last updated
02/03/2017
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