Healthcare Provider Details

I. General information

NPI: 1790088565
Provider Name (Legal Business Name): LINDY LIEPKE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2010
Last Update Date: 05/29/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 TULLISON RD
KANSAS CITY MO
64116-2640
US

IV. Provider business mailing address

1301 TULLISON RD
KANSAS CITY MO
64116-2640
US

V. Phone/Fax

Practice location:
  • Phone: 816-768-6054
  • Fax:
Mailing address:
  • Phone: 816-768-6054
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2630
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number8661
License Number StateMN
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5434
License Number StateOR
# 4
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number28326
License Number StateFL
# 5
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2005029648
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: