Donna Wyly
Nurse Practitioner - Pediatrics
2401 Gillham Rd
Kansas City
, Missouri 64108-4619
Donna Wyly
Nurse Practitioner - Pediatrics
2401 Gillham Rd
Kansas City
, Missouri 64108-4619
(816) 302-9939
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About
Features
Specialties
- Nurse Practitioner - Pediatrics
Languages spoken
- English
Location
First Address
- Donna Wyly
- Attn: Provider Enrollment Department 2401 Gillham Road
- Kansas City, MO
- Zip : 64108-4619
- Fax : (816) 302-9939
- Phone : (816) 701-5200
Second Address
- Donna Wyly
- 2401 Gillham Rd
- Kansas City, MO
- Zip : 64108-4619
- Phone : (816) 234-3665
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LP0200X | Nurse Practitioner - Pediatrics | 125887 | MO |
National Provider Identifier
| NPI | 1013975267 |
|---|---|
| Provider Name | Donna Wyly |
| First Address | Kansas City, MO 64108-4619 |
| Second Address | Kansas City, MO 64108-4619 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 03/05/2006 |
| Last Update Date | 15/04/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 428123004 | (05) | MO |
| P51613 | (02) | MO |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.