Healthcare Provider Details

I. General information

NPI: 1275112765
Provider Name (Legal Business Name): MCKAYLEIGH ANDRUS-BEARDEN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2021
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3515 BROADWAY BLVD
KANSAS CITY MO
64111-2501
US

IV. Provider business mailing address

3515 BROADWAY BLVD
KANSAS CITY MO
64111-2501
US

V. Phone/Fax

Practice location:
  • Phone: 816-753-5144
  • Fax: 855-737-0585
Mailing address:
  • Phone: 816-753-5144
  • Fax: 855-737-0585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2024031693
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: