Healthcare Provider Details

I. General information

NPI: 1417889627
Provider Name (Legal Business Name): KACIE HERBEL OD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4700 W 135TH ST
LEAWOOD KS
66224-8714
US

IV. Provider business mailing address

4700 W 135TH ST
LEAWOOD KS
66224-8714
US

V. Phone/Fax

Practice location:
  • Phone: 913-681-8555
  • Fax:
Mailing address:
  • Phone: 913-681-8555
  • Fax: 913-273-6981

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2276
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: