Healthcare Provider Details

I. General information

NPI: 1245154087
Provider Name (Legal Business Name): AVERIE DIANE BROWN PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8200 W 71ST ST
SHAWNEE MISSION KS
66204-1715
US

IV. Provider business mailing address

14715 S SUMMERTREE LN
OLATHE KS
66062-4757
US

V. Phone/Fax

Practice location:
  • Phone: 913-993-6200
  • Fax:
Mailing address:
  • Phone: 620-899-3421
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number11-08177
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: