Healthcare Provider Details

I. General information

NPI: 1437624327
Provider Name (Legal Business Name): YESENIA BLANCA OLMEDO NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: YESENIA BLANCA OLMEDO FLORES

II. Dates (important events)

Enumeration Date: 10/08/2018
Last Update Date: 04/08/2024
Certification Date: 04/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6730 W 153RD ST
OVERLAND PARK KS
66223-3158
US

IV. Provider business mailing address

6730 W 153RD ST
OVERLAND PARK KS
66223-3158
US

V. Phone/Fax

Practice location:
  • Phone: 913-344-4003
  • Fax:
Mailing address:
  • Phone: 913-344-4003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5378407032
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number53-78407-032
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: