Provider Demographics
NPI:1265605331
Name:O'BRIEN, KELLY ANNE (MD)
Entity type:Individual
Prefix:MS
First Name:KELLY
Middle Name:ANNE
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:600 NW MURRAY RD STE 210
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64081-1245
Mailing Address - Country:US
Mailing Address - Phone:816-524-2626
Mailing Address - Fax:816-524-0173
Practice Address - Street 1:600 NW MURRAY RD STE 210
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64081-1245
Practice Address - Country:US
Practice Address - Phone:816-524-2626
Practice Address - Fax:816-524-0173
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-09
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2010036796207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine