Healthcare Provider Details

I. General information

NPI: 1659151900
Provider Name (Legal Business Name): ALESHA MAHONE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2023
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11729 ROE AVE
LEAWOOD KS
66211-2605
US

IV. Provider business mailing address

11729 ROE AVE
LEAWOOD KS
66211-2605
US

V. Phone/Fax

Practice location:
  • Phone: 816-474-4920
  • Fax: 913-696-9895
Mailing address:
  • Phone: 913-345-8404
  • Fax: 913-696-9895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number53-84594-042
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: