Provider Demographics
NPI:1992544514
Name:SEEFELDT, KELLIE (FNP-C)
Entity type:Individual
Prefix:
First Name:KELLIE
Middle Name:
Last Name:SEEFELDT
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11305 CODY ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-4300
Mailing Address - Country:US
Mailing Address - Phone:816-305-9535
Mailing Address - Fax:
Practice Address - Street 1:7025 COLLEGE BLVD STE 200
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1885
Practice Address - Country:US
Practice Address - Phone:913-338-4515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-22
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023049077363LF0000X
KS53-83111-082363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily