Provider Demographics
NPI:1124642145
Name:DONNELLY, CLAIRE ELIZABETH (NP)
Entity type:Individual
Prefix:MS
First Name:CLAIRE
Middle Name:ELIZABETH
Last Name:DONNELLY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4963 W. 135TH 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:913-814-8222
Mailing Address - Fax:913-897-5574
Practice Address - Street 1:4963 W. 135TH 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:913-814-8222
Practice Address - Fax:913-897-5574
Is Sole Proprietor?:No
Enumeration Date:2020-06-05
Last Update Date:2022-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013011059163W00000X
KS53-79942-081363LF0000X
MO2020018077363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse