Healthcare Provider Details

I. General information

NPI: 1154868008
Provider Name (Legal Business Name): KRISHNA PATEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2017
Last Update Date: 03/14/2026
Certification Date: 03/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13795 S MUR LEN RD STE 203
OLATHE KS
66062-1096
US

IV. Provider business mailing address

13795 S MUR LEN RD STE 203
OLATHE KS
66062-1096
US

V. Phone/Fax

Practice location:
  • Phone: 913-600-4429
  • Fax: 913-600-4482
Mailing address:
  • Phone: 913-600-4429
  • Fax: 913-600-4482

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number15-02057
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: