Provider Demographics
NPI:1306642822
Name:THOMAS, CARLY RENE (WHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:CARLY
Middle Name:RENE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8716 PARIS AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64153-1559
Mailing Address - Country:US
Mailing Address - Phone:913-449-2085
Mailing Address - Fax:
Practice Address - Street 1:9119 W 74TH ST STE 300
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66204-2229
Practice Address - Country:US
Practice Address - Phone:913-677-3113
Practice Address - Fax:913-677-4514
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-24
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-84081-042207V00000X, 363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty