Provider Demographics
NPI:1326730367
Name:MAX-WELL URGENT CARE LLC
Entity Type:Organization
Organization Name:MAX-WELL URGENT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN, NP-C/CEO
Authorized Official - Prefix:
Authorized Official - First Name:KELLI
Authorized Official - Middle Name:
Authorized Official - Last Name:MAXWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-271-5878
Mailing Address - Street 1:14675 170TH ST
Mailing Address - Street 2:
Mailing Address - City:BONNER SPRINGS
Mailing Address - State:KS
Mailing Address - Zip Code:66012-7826
Mailing Address - Country:US
Mailing Address - Phone:913-271-5878
Mailing Address - Fax:
Practice Address - Street 1:15604 PINEHURST DR STE 3A
Practice Address - Street 2:
Practice Address - City:BASEHOR
Practice Address - State:KS
Practice Address - Zip Code:66007-8234
Practice Address - Country:US
Practice Address - Phone:913-271-5878
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-25
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty