Healthcare Provider Details

I. General information

NPI: 1467326744
Provider Name (Legal Business Name): ALIYAH ELLIS APRN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALIYAH HAYNES

II. Dates (important events)

Enumeration Date: 10/01/2025
Last Update Date: 09/12/2026
Certification Date: 09/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13470 S ARAPAHO DR STE 180
OLATHE KS
66062-1656
US

IV. Provider business mailing address

10420 S RIDGEVIEW RD # 1033
OLATHE KS
66061-6438
US

V. Phone/Fax

Practice location:
  • Phone: 913-421-3366
  • Fax:
Mailing address:
  • Phone: 913-421-3366
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number84893
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: