MEDICARE: KYRSTEN MARIE RODENBEEK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	7069	KS

General Provider Information

NPI Number	:	1881840387
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYRSTEN MARIE RODENBEEK

Provider Business Mailing Address
First Line	:	100 N 7TH ST STE 211
Second Line	:
City	:	SALINA
State	:	KS
Zip	:	67401-2604
Country	:	US
Telephone Number	:	785-404-8431
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 N 7TH ST STE 211
Second Line	:
City	:	SALINA
State	:	KS
Zip	:	67401-2604
Country	:	US
Telephone Number	:	785-404-8431
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2008
Last Update Date	:	09/18/2023

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