Healthcare Provider Details

I. General information

NPI: 1205641016
Provider Name (Legal Business Name): KARA ANN STANLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2025
Last Update Date: 02/10/2025
Certification Date: 02/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4251 NORTHERN AVE
KANSAS CITY MO
64133-1593
US

IV. Provider business mailing address

31460 W 135TH ST
OLATHE KS
66061-9090
US

V. Phone/Fax

Practice location:
  • Phone: 816-769-0103
  • Fax:
Mailing address:
  • Phone: 913-271-8527
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number2005018031
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number13-93698-111
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: