Healthcare Provider Details
I. General information
NPI: 1528611399
Provider Name (Legal Business Name): LYNSEY N RALSTON AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/22/2019
Last Update Date: 08/13/2024
Certification Date: 08/13/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4880 NE GOODVIEW CIR
LEES SUMMIT MO
64064-1996
US
IV. Provider business mailing address
5101 COLLEGE BLVD
LEAWOOD KS
66211-1614
US
V. Phone/Fax
- Phone: 816-478-4200
- Fax: 816-875-2598
- Phone: 816-478-4200
- Fax: 816-875-2598
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 231H00000X |
| Taxonomy | Audiologist |
| License Number | 2378 |
| License Number State | KS |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 237700000X |
| Taxonomy | Hearing Instrument Specialist |
| License Number | 1794 |
| License Number State | KS |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 231H00000X |
| Taxonomy | Audiologist |
| License Number | 2019026087 |
| License Number State | MO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: