Healthcare Provider Details

I. General information

NPI: 1801080049
Provider Name (Legal Business Name): JAMES KENT WHALEY R.N.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2007
Last Update Date: 12/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10895 GRANDVIEW DR
OVERLAND PARK KS
66210-1532
US

IV. Provider business mailing address

10895 GRANDVIEW ST
OVERLAND PARK KS
66210-1532
US

V. Phone/Fax

Practice location:
  • Phone: 877-542-9238
  • Fax:
Mailing address:
  • Phone: 877-542-9238
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number13-66463-032
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: