Provider Demographics
NPI:1417933391
Name:CADE, ROSEANN K (PT)
Entity Type:Individual
Prefix:MRS
First Name:ROSEANN
Middle Name:K
Last Name:CADE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:ROSEANN
Other - Middle Name:K
Other - Last Name:DEVANEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:7111 E 21ST ST N STE D
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-1176
Mailing Address - Country:US
Mailing Address - Phone:316-219-8484
Mailing Address - Fax:316-858-2810
Practice Address - Street 1:1999 N AMIDON AVE STE 100
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67203-2122
Practice Address - Country:US
Practice Address - Phone:316-262-8800
Practice Address - Fax:620-708-4022
Is Sole Proprietor?:No
Enumeration Date:2005-12-21
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-03554225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200384070AMedicaid
141057Medicare PIN