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General NPI Number Information
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NPI Number | 1144106121
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Entity Type | Organization
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Legal Business Name | MAX-WELL PRIMARY CARE LLC
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Dates
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Enumeration Date | 08/14/2025
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 15604 PINEHURST DR STE 4
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City | BASEHOR
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State | KS
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Zip | 66007-8234
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Country | US
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Telephone | 913-662-0043
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Fax | 913-662-0043
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Provider Business Mailing Address
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Address Line | 15604 PINEHURST DR STE 4
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City | BASEHOR
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State | KS
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Zip | 66007-8234
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Country | US
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Telephone | 913-662-0043
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Fax | 913-662-0043
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Authorized Official
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Title or Position | OWNER
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Name | KELLI MAXWELL KELLI MAXWELL
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Credential | APRN, NP-C
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Telephone | 913-662-0043
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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