Provider Demographics
NPI:1790235737
Name:RIEKE, KAYLEE (APRN)
Entity Type:Individual
Prefix:
First Name:KAYLEE
Middle Name:
Last Name:RIEKE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:KAYLEE
Other - Middle Name:
Other - Last Name:JOERGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:901 E 104TH ST
Mailing Address - Street 2:MAILSTOP 400S
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-4517
Mailing Address - Country:US
Mailing Address - Phone:816-599-9499
Mailing Address - Fax:816-932-9670
Practice Address - Street 1:8501 W 95TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-3220
Practice Address - Country:US
Practice Address - Phone:913-323-8880
Practice Address - Fax:913-323-8881
Is Sole Proprietor?:No
Enumeration Date:2016-10-13
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016036421363LF0000X
KS5377405121363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily