Provider Demographics
NPI:1225471717
Name:FLEXMAN, KALLIE (RN)
Entity Type:Individual
Prefix:
First Name:KALLIE
Middle Name:
Last Name:FLEXMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:KALLIE
Other - Middle Name:
Other - Last Name:FOGLESONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:230 W 2ND ST APT 3221
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64105-2177
Mailing Address - Country:US
Mailing Address - Phone:816-522-6205
Mailing Address - Fax:
Practice Address - Street 1:2618 SW RIVER TRAIL RD
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64082-7806
Practice Address - Country:US
Practice Address - Phone:816-522-6205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-15
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012010424163WC0200X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine