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NPI Code Detail

MEDICARE: BROOKE MCKIBBEN

MEDICARE: BROOKE MCKIBBEN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker2025033577MO

General Provider Information

NPI Number : 1225902810
Entity Type Code : Individual
Provider Name (Legal Business Name) : BROOKE MCKIBBEN
Provider Business Mailing Address
First Line : 1555 NE RICE RD
Second Line :
City : LEES SUMMIT
State : MO
Zip : 64086-5849
Country : US
Telephone Number : 816-347-3069
Fax Number :
Provider Business Practice Location Address
First Line : 5904 E BANNISTER RD
Second Line :
City : KANSAS CITY
State : MO
Zip : 64134-1141
Country : US
Telephone Number : 816-966-0900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/06/2025
Last Update Date : 06/08/2026

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Directions to “ BROOKE MCKIBBEN ” Practice Location

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