Provider Demographics
NPI:1922506187
Name:SHRIWISE, KALEIGH (PA-C)
Entity Type:Individual
Prefix:MS
First Name:KALEIGH
Middle Name:
Last Name:SHRIWISE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14500 REEDS ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66223-1232
Mailing Address - Country:US
Mailing Address - Phone:913-708-5690
Mailing Address - Fax:
Practice Address - Street 1:14500 REEDS ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66223-1232
Practice Address - Country:US
Practice Address - Phone:913-708-5690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-23
Last Update Date:2018-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant