Healthcare Provider Details

I. General information

NPI: 1497610596
Provider Name (Legal Business Name): LILLY WESTPHAL RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9532 ROSEWOOD DR APT 211
OVERLAND PARK KS
66207-3231
US

IV. Provider business mailing address

9532 ROSEWOOD DR APT 211
OVERLAND PARK KS
66207-3231
US

V. Phone/Fax

Practice location:
  • Phone: 816-225-8837
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number86329440
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: