Healthcare Provider Details

I. General information

NPI: 1629924501
Provider Name (Legal Business Name): DANA LEIGH KELLY MSN-FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2026
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5100 W 110TH ST STE 200
OVERLAND PARK KS
66211-1215
US

IV. Provider business mailing address

5100 W 110TH ST STE 200
OVERLAND PARK KS
66211-1215
US

V. Phone/Fax

Practice location:
  • Phone: 913-934-4300
  • Fax: 913-906-2339
Mailing address:
  • Phone: 913-934-4300
  • Fax: 913-906-2339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2026004617
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: