Provider Demographics
NPI:1770047672
Name:DELAY-PAPA, KIRSTEN BELLE
Entity Type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:BELLE
Last Name:DELAY-PAPA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5675 ROE BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:ROELAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66205-2538
Mailing Address - Country:US
Mailing Address - Phone:913-432-2080
Mailing Address - Fax:913-432-5183
Practice Address - Street 1:9300 MEADOW VIEW DR
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66227-7288
Practice Address - Country:US
Practice Address - Phone:913-601-4500
Practice Address - Fax:913-721-3316
Is Sole Proprietor?:No
Enumeration Date:2019-01-24
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS15-02868363A00000X
WAPA61272396363A00000X
COPA.0006331363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant