Healthcare Provider Details

I. General information

NPI: 1003732983
Provider Name (Legal Business Name): HEALING HANDS PRIMARY CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
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: 913-436-7949
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LC1500X
TaxonomyCommunity Health Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. MICHELLE DAWN CALLICOAT
Title or Position: EXECUTIVE DIRECTOR
Credential: NP
Phone: 360-932-9640