Provider Demographics
NPI:1437624327
Name:OLMEDO, YESENIA BLANCA (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:YESENIA
Middle Name:BLANCA
Last Name:OLMEDO
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:MRS
Other - First Name:YESENIA
Other - Middle Name:BLANCA
Other - Last Name:OLMEDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FLORES
Mailing Address - Street 1:6730 W 153RD ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66223-3158
Mailing Address - Country:US
Mailing Address - Phone:913-344-4003
Mailing Address - Fax:
Practice Address - Street 1:6730 W 153RD ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66223-3158
Practice Address - Country:US
Practice Address - Phone:913-344-4003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS5378407032363LF0000X
KS53-78407-032363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily