Provider Demographics
NPI:1467940098
Name:O'REILLY, LINDSAY F (RD, LD)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:F
Last Name:O'REILLY
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:
Other - Last Name:MOONEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, LD
Mailing Address - Street 1:14549 WINDSOR ST
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66224-3716
Mailing Address - Country:US
Mailing Address - Phone:191-352-3305
Mailing Address - Fax:
Practice Address - Street 1:14549 WINDSOR ST
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66224-3716
Practice Address - Country:US
Practice Address - Phone:913-523-3059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-30
Last Update Date:2018-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2247133V00000X
MO2005012273133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered