Provider Demographics
NPI:1841611647
Name:LAHEY, MARISSA ALLISON (APRN-BC)
Entity Type:Individual
Prefix:MS
First Name:MARISSA
Middle Name:ALLISON
Last Name:LAHEY
Suffix:
Gender:F
Credentials:APRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4901 W 136TH ST
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66224
Mailing Address - Country:US
Mailing Address - Phone:913-488-2012
Mailing Address - Fax:913-890-7285
Practice Address - Street 1:4901 W 136TH ST
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66224
Practice Address - Country:US
Practice Address - Phone:913-488-2012
Practice Address - Fax:913-890-7285
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-20
Last Update Date:2018-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS76187363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health