Provider Demographics
NPI:1326091539
Name:SZALA, KELLY LOUGHRIE (WHNP)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:LOUGHRIE
Last Name:SZALA
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5844 NW BARRY RD
Mailing Address - Street 2:STE. 110
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64154-1465
Mailing Address - Country:US
Mailing Address - Phone:816-880-6100
Mailing Address - Fax:816-746-1226
Practice Address - Street 1:5844 NW BARRY RD
Practice Address - Street 2:STE. 110
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64154-1465
Practice Address - Country:US
Practice Address - Phone:816-880-6100
Practice Address - Fax:816-746-1226
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO145912363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1326091539Medicaid
MOH71000027Medicare PIN