Healthcare Provider Details

I. General information

NPI: 1972427284
Provider Name (Legal Business Name): DYLAN ANDREW MCCOLLAR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10500 QUIVIRA RD
OVERLAND PARK KS
66215-2373
US

IV. Provider business mailing address

11306 W 68TH ST
SHAWNEE KS
66203-3714
US

V. Phone/Fax

Practice location:
  • Phone: 913-541-5000
  • Fax:
Mailing address:
  • Phone: 316-655-5691
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number53-85906-111
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: