Individual
KAITLYNN ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10701 NALL AVE STE 100, OVERLAND PARK, KS 66211-1244
(913) 338-5585
(913) 338-3228
Mailing address
10701 NALL AVE STE 100, OVERLAND PARK, KS 66211-1244
(913) 338-5585
(913) 338-3228
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
14230205-1206
UT
363A00000X
Physician Assistant
Primary
—
—
363AM0700X
Medical Physician Assistant
14230205-1206
UT
363AS0400X
Surgical Physician Assistant
14230205-1206
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1502919
KS LICENSE
KS
Enumeration date
11/18/2022
Last updated
02/09/2026
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