Healthcare Provider Details

I. General information

NPI: 1164338679
Provider Name (Legal Business Name): MAKENZIE BICKERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4701 COLLEGE BLVD STE 115
LEAWOOD KS
66211-1608
US

IV. Provider business mailing address

4701 COLLEGE BLVD STE 115
LEAWOOD KS
66211-1608
US

V. Phone/Fax

Practice location:
  • Phone: 660-620-9045
  • Fax:
Mailing address:
  • Phone: 660-620-9045
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MAKENZIE PAIGE BICKERS
Title or Position: MANAGING MEMBER
Credential: PMHNP-BC
Phone: 660-620-9045