Provider Demographics
NPI:1215308762
Name:KIELY, LINDSAY (CPNP-PC)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:KIELY
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4400 BROADWAY
Mailing Address - Street 2:SUITE#206
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-3498
Mailing Address - Country:US
Mailing Address - Phone:816-561-8100
Mailing Address - Fax:816-561-8154
Practice Address - Street 1:4400 BROADWAY
Practice Address - Street 2:SUITE#206
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-3498
Practice Address - Country:US
Practice Address - Phone:816-561-8100
Practice Address - Fax:816-561-8154
Is Sole Proprietor?:No
Enumeration Date:2015-10-09
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015036188363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics