Healthcare Provider Details

I. General information

NPI: 1841773496
Provider Name (Legal Business Name): KELSEY NICOLE WAMPLER RN, NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2018
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8765 N AMBASSADOR DR
KANSAS CITY MO
64154-7710
US

IV. Provider business mailing address

8416 W 135TH ST
OVERLAND PARK KS
66223-1158
US

V. Phone/Fax

Practice location:
  • Phone: 913-297-7472
  • Fax:
Mailing address:
  • Phone: 913-851-3800
  • Fax: 913-851-9888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2018027828
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number2013021009
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number78399
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: