Healthcare Provider Details

I. General information

NPI: 1265225122
Provider Name (Legal Business Name): MICHELLE DAWN CALLICOAT ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELLE DAWN DARNELL RN

II. Dates (important events)

Enumeration Date: 05/23/2025
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5800 FOXRIDGE DR STE 308
MISSION KS
66202-2347
US

IV. Provider business mailing address

5800 FOXRIDGE DR STE 308
MISSION KS
66202-2347
US

V. Phone/Fax

Practice location:
  • Phone: 913-436-7949
  • Fax:
Mailing address:
  • Phone: 913-261-9205
  • Fax: 913-261-9461

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5385871051
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: