Healthcare Provider Details

I. General information

NPI: 1518398684
Provider Name (Legal Business Name): SYBA BIRTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2013
Last Update Date: 02/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

721 N 31ST ST
KANSAS CITY KS
66102-3964
US

IV. Provider business mailing address

721 N 31ST ST
KANSAS CITY KS
66102-3964
US

V. Phone/Fax

Practice location:
  • Phone: 913-620-1505
  • Fax: 913-884-1970
Mailing address:
  • Phone: 913-620-1505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QB0400X
TaxonomyBirthing Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KATHERINE YUNGHANS
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: CNM
Phone: 913-620-1505