Healthcare Provider Details

I. General information

NPI: 1528943511
Provider Name (Legal Business Name): MRS. FLANNERY QUINN BEELER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: FLANNERY QUINN KOELLIKER-LANE

II. Dates (important events)

Enumeration Date: 08/08/2025
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 CORPORATE LAKE DR STE A
COLUMBIA MO
65203-7290
US

IV. Provider business mailing address

4001 NE 59TH ST
KANSAS CITY MO
64119-2272
US

V. Phone/Fax

Practice location:
  • Phone: 573-380-5557
  • Fax:
Mailing address:
  • Phone: 816-729-3160
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number2025034648
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number4135
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: