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NPI 1467315986

NPI 1467315986 : DEVOTED MEDICAL KS PA : LENEXA, KS

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General NPI Number Information
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    NPI Number           |    1467315986
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    Entity Type          |    Organization 
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    Legal Business Name  |    DEVOTED MEDICAL KS PA 
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Dates
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    Enumeration Date     |    12/03/2025
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    Last Update Date     |    12/03/2025
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Provider Practice Location Address
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    Address Line         |    12345 W 95TH ST FL 2 
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    City                 |    LENEXA
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    State                |    KS
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    Zip                  |    66215-3853
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    Country              |    US
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    Telephone            |    866-849-0692
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    12345 W 95TH ST FL 2 
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    City                 |    LENEXA
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    State                |    KS
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    Zip                  |    66215-3853
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    PRACTICE OPERATIONS
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    Name                 |     CELY  COURTNEY 
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    Credential           |    
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    Telephone            |    866-849-0692
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    363LP2300X
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    Taxonomy Name        |    Primary Care Nurse Practitioner
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    License Number       |    
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    License Number State |    
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