Healthcare Provider Details

I. General information

NPI: 1326062399
Provider Name (Legal Business Name): MRS. KELLEY DAWN BIEBERLE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1102 HOSPITAL DR
MCPHERSON KS
67460-2318
US

IV. Provider business mailing address

1901 E 1ST ST
NEWTON KS
67114-5010
US

V. Phone/Fax

Practice location:
  • Phone: 316-284-6400
  • Fax: 316-284-6352
Mailing address:
  • Phone: 316-284-6400
  • Fax: 316-284-6352

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number07074
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: