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Individual

KRISTINE KELLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
15512 W 113TH ST, LENEXA, KS 66219-5100
(816) 922-2522
Mailing address
309 N IOWA ST, OLATHE, KS 66061-3216
(480) 203-6914

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
K04-61-8789
KS

Other

Enumeration date
12/23/2025
Last updated
12/23/2025
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