Healthcare Provider Details

I. General information

NPI: 1285164756
Provider Name (Legal Business Name): MARLANA MICHELLE RAY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2017
Last Update Date: 09/12/2025
Certification Date: 10/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2750 CLAY EDWARDS DR STE 312
NORTH KANSAS CITY MO
64116-3256
US

IV. Provider business mailing address

9411 N OAK TRFY STE LL1
KANSAS CITY MO
64155-2262
US

V. Phone/Fax

Practice location:
  • Phone: 816-691-1185
  • Fax: 816-346-7085
Mailing address:
  • Phone: 816-691-1655
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberRS2019-0631
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number2024022799
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number35.142117
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: