Healthcare Provider Details

I. General information

NPI: 1851109029
Provider Name (Legal Business Name): CARESSA KUY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2024
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1803 W 6TH ST
LAWRENCE KS
66044-1710
US

IV. Provider business mailing address

1312 W 6TH ST
LAWRENCE KS
66044-2219
US

V. Phone/Fax

Practice location:
  • Phone: 785-841-7297
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number76078
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number53-84019
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: