Provider Demographics
NPI:1386200442
Name:GILBERT, KENYADA (DNP)
Entity type:Individual
Prefix:DR
First Name:KENYADA
Middle Name:
Last Name:GILBERT
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5407 JOHNSON DR
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66205-2912
Mailing Address - Country:US
Mailing Address - Phone:913-362-0220
Mailing Address - Fax:913-362-0440
Practice Address - Street 1:5407 JOHNSON DR
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:KS
Practice Address - Zip Code:66205-2912
Practice Address - Country:US
Practice Address - Phone:913-362-0220
Practice Address - Fax:913-362-0440
Is Sole Proprietor?:No
Enumeration Date:2019-05-14
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020032914363LP2300X
COC-APN.0001444-C-NP363LP2300X
MS903236363LP2300X
KS79765363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care