Healthcare Provider Details

I. General information

NPI: 1376984153
Provider Name (Legal Business Name): KIMBERLY RAPP MS CCC SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KIMBERLY ANN SMITH

II. Dates (important events)

Enumeration Date: 07/09/2013
Last Update Date: 06/25/2025
Certification Date: 06/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15612 HADSELL RD
KINGSVILLE MO
64061-9007
US

IV. Provider business mailing address

15612 HADSELL RD
KINGSVILLE MO
64061-9007
US

V. Phone/Fax

Practice location:
  • Phone: 913-710-6819
  • Fax:
Mailing address:
  • Phone: 913-710-6819
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number2511
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number2004028845
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: