Healthcare Provider Details

I. General information

NPI: 1861331282
Provider Name (Legal Business Name): SYDNEE FREEZE RDMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2026
Last Update Date: 03/28/2026
Certification Date: 03/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22712 MIDLAND DR
SHAWNEE KS
66226-3553
US

IV. Provider business mailing address

22712 MIDLAND DR
SHAWNEE KS
66226-3553
US

V. Phone/Fax

Practice location:
  • Phone: 913-543-8565
  • Fax: 913-543-3014
Mailing address:
  • Phone: 913-543-8565
  • Fax: 913-543-3014

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2471S1302X
TaxonomySonography Radiologic Technologist
License Number
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: