Individual
KELLY BLICKHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4100 W 59TH ST, FAIRWAY, KS 66205-3102
(833) 278-7770
Mailing address
4100 W 59TH ST, FAIRWAY, KS 66205-3102
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
14-167324-121
KS
Other
Enumeration date
12/18/2025
Last updated
12/18/2025
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