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NPI Code Detail

MEDICARE: DEER CREEK BEHAVIORAL HEALTH SERVICES

MEDICARE: DEER CREEK BEHAVIORAL HEALTH SERVICES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number : 1265142673
Entity Type Code : Organization
Provider Name (Legal Business Name) : DEER CREEK BEHAVIORAL HEALTH SERVICES
Provider Business Mailing Address
First Line : 6240 W 135TH ST STE 226
Second Line :
City : OVERLAND PARK
State : KS
Zip : 66223-4856
Country : US
Telephone Number : 913-229-9804
Fax Number :
Provider Business Practice Location Address
First Line : 6240 W 135TH ST STE 200
Second Line :
City : OVERLAND PARK
State : KS
Zip : 66223-4849
Country : US
Telephone Number : 913-710-1518
Fax Number :
Authorized Official
Title or Position : NURSE PRACTITIONER
Name : SILVERUS KIMELI
Credential :
Telephone Number : 913-710-1518
Provider Enumeration Date : 11/28/2022
Last Update Date : 06/19/2023

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Directions to “DEER CREEK BEHAVIORAL HEALTH SERVICES ” Practice Location

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