Healthcare Provider Details

I. General information

NPI: 1366126898
Provider Name (Legal Business Name): MADHAVI K LIYANAGE FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2023
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20805 W 151ST ST STE 400
OLATHE KS
66061-7249
US

IV. Provider business mailing address

20805 W 151ST ST
OLATHE KS
66061-7249
US

V. Phone/Fax

Practice location:
  • Phone: 913-588-1227
  • Fax:
Mailing address:
  • Phone: 913-588-1227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2023008360
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number53-81954-082
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: