Healthcare Provider Details

I. General information

NPI: 1063350734
Provider Name (Legal Business Name): MOIRA CAPELA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 03/24/2026
Certification Date: 03/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25055 W VALLEY PKWY STE 220
OLATHE KS
66061-8450
US

IV. Provider business mailing address

25055 W VALLEY PKWY STE 220
OLATHE KS
66061-8450
US

V. Phone/Fax

Practice location:
  • Phone: 913-378-1061
  • Fax: 913-904-1399
Mailing address:
  • Phone: 913-378-1061
  • Fax: 913-904-1399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number53-85429-081
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: