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General NPI Number Information
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NPI Number | 1306642822
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Entity Type | Individual
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Provider Name | CARLY RENE THOMAS WHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 02/24/2025
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Last Update Date | 04/08/2025
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Provider Practice Location Address
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Address Line | 9119 W 74TH ST STE 300
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City | OVERLAND PARK
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State | KS
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Zip | 66204-2229
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Country | US
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Telephone | 913-677-3113
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Fax | 913-677-4514
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Provider Business Mailing Address
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Address Line | 8716 PARIS AVE
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City | KANSAS CITY
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State | MO
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Zip | 64153-1559
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Country | US
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Telephone | 913-449-2085
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 53-84081-042
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 363LX0001X
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Taxonomy Name | Obstetrics & Gynecology Nurse Practitioner
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License Number | 53-84081-042
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License Number State | KS
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