Healthcare Provider Details

I. General information

NPI: 1780722462
Provider Name (Legal Business Name): KRISTI LYNN SIMPSON MOT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 06/10/2024
Certification Date: 06/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7211 W 110TH ST
OVERLAND PARK KS
66210-2339
US

IV. Provider business mailing address

8823 PRODUCTION LN
OOLTEWAH TN
37363-6511
US

V. Phone/Fax

Practice location:
  • Phone: 913-451-7372
  • Fax: 913-451-7375
Mailing address:
  • Phone: 816-226-4011
  • Fax: 816-524-6115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number2006016732
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number17-01514
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: