Individual
MS. KELLY S TIEVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2401 GILLHAM RD, CHILDREN'S MERCY HOSPITAL, KANSAS CITY, MO 64108-4619
(816) 234-3041
Mailing address
2401 GILLHAM RD, CHILDREN'S MERCY HOSPITAL, KANSAS CITY, MO 64108-4619
(816) 234-3041
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
05-32228
KS
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
2006034491
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004000215J
HUMANA
—
05
—
32542500
—
WI
Enumeration date
05/15/2006
Last updated
03/04/2015
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