MEDICARE: KRISTINE MARIE TIMMERMEYER

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
1	225X00000X	Occupational Therapist	002879	MO

General Provider Information

NPI Number	:	1851418479
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTINE MARIE TIMMERMEYER

Provider Business Mailing Address
First Line	:	9411 N OAK TRFY
Second Line	:	SUITE LL1
City	:	KANSAS CITY
State	:	MO
Zip	:	64155-2233
Country	:	US
Telephone Number	:	816-436-7072
Fax Number	:	816-436-2743

Provider Business Practice Location Address
First Line	:	2900 CLAY EDWARDS DR
Second Line	:
City	:	NORTH KANSAS CITY
State	:	MO
Zip	:	64116-3221
Country	:	US
Telephone Number	:	816-346-7400
Fax Number	:	816-346-7404

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/26/2007
Last Update Date	:	07/08/2007

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Directions to “ KRISTINE MARIE TIMMERMEYER ” Practice Location

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