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General NPI Number Information
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NPI Number | 1659045599
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Entity Type | Individual
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Provider Name | NICHOLE KRYSTYNA SCHAFER PTA
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Gender | Female
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Dates
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Enumeration Date | 08/04/2021
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Last Update Date | 08/04/2021
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Provider Practice Location Address
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Address Line | 9701 MONROVIA ST
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City | LENEXA
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State | KS
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Zip | 66215-1564
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Country | US
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Telephone | 913-492-1130
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Fax |
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Provider Business Mailing Address
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Address Line | 2705 MCGEE TRFY APT 4309
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City | KANSAS CITY
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State | MO
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Zip | 64108-3474
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Country | US
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Telephone | 440-263-4160
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 14-03858
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License Number State | KS
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