Healthcare Provider Details

I. General information

NPI: 1194055111
Provider Name (Legal Business Name): JOHNI KILTON WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/14/2010
Last Update Date: 08/21/2024
Certification Date: 08/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9119 W 74TH ST STE 268
MERRIAM KS
66204-2268
US

IV. Provider business mailing address

9119 W 74TH ST STE 268
MERRIAM KS
66204-2268
US

V. Phone/Fax

Practice location:
  • Phone: 913-780-4300
  • Fax: 913-780-4250
Mailing address:
  • Phone: 913-780-4300
  • Fax: 913-780-4250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberA03322 APN
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number53-75299-111
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: