Healthcare Provider Details

I. General information

NPI: 1336889849
Provider Name (Legal Business Name): KATHERINE A PHALEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2022
Last Update Date: 07/24/2025
Certification Date: 07/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7405 RENNER RD
SHAWNEE KS
66217-9414
US

IV. Provider business mailing address

2106 OLATHE BLVD MAILSTOP 4004
KANSAS CITY KS
66160-0001
US

V. Phone/Fax

Practice location:
  • Phone: 913-588-6300
  • Fax: 913-274-3515
Mailing address:
  • Phone: 913-588-6300
  • Fax: 913-274-3515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number04-51308
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: