Provider Demographics
NPI:1912703026
Name:GREENE, KELLI ELAINE
Entity type:Individual
Prefix:
First Name:KELLI
Middle Name:ELAINE
Last Name:GREENE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:KELLI
Other - Middle Name:ELAINE
Other - Last Name:STEINKAMP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:928 SW LOULA DR
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64081-2451
Mailing Address - Country:US
Mailing Address - Phone:816-309-6655
Mailing Address - Fax:
Practice Address - Street 1:4801 E LINWOOD BLVD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64128-2226
Practice Address - Country:US
Practice Address - Phone:816-861-4700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-20
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018010769163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse