Provider Demographics
NPI:1316513260
Name:CLEAVER, KYESIS MONE' (FNP)
Entity type:Individual
Prefix:
First Name:KYESIS
Middle Name:MONE'
Last Name:CLEAVER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14701 GRAND SUMMIT BLVD APT 102
Mailing Address - Street 2:
Mailing Address - City:GRANDVIEW
Mailing Address - State:MO
Mailing Address - Zip Code:64030-1931
Mailing Address - Country:US
Mailing Address - Phone:816-529-0485
Mailing Address - Fax:
Practice Address - Street 1:9100 PARK ST STE 100
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66215-3353
Practice Address - Country:US
Practice Address - Phone:913-712-9680
Practice Address - Fax:877-384-3106
Is Sole Proprietor?:No
Enumeration Date:2021-06-01
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS5380334062363LF0000X
MO2021019487363LF0000X
KS53-80334363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily