Provider Demographics
NPI:1811753197
Name:KLEYH, AMANDA GAYLE (FNP-C)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:GAYLE
Last Name:KLEYH
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16405 S SCOTT RD
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:MO
Mailing Address - Zip Code:64080-8341
Mailing Address - Country:US
Mailing Address - Phone:816-392-7702
Mailing Address - Fax:
Practice Address - Street 1:315 W 75TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-5738
Practice Address - Country:US
Practice Address - Phone:816-361-4668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024005127363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily