Healthcare Provider Details

I. General information

NPI: 1770232043
Provider Name (Legal Business Name): BRIANNA HAFENSTINE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2022
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20930 W 151ST ST
OLATHE KS
66061-7228
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 Number04-52948
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: