Provider Demographics
NPI:1497864292
Name:RUMP, BRENDA SPRIER (LP)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:SPRIER
Last Name:RUMP
Suffix:
Gender:F
Credentials:LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5555 W 58TH ST
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66202-2722
Mailing Address - Country:US
Mailing Address - Phone:913-432-2080
Mailing Address - Fax:913-432-5183
Practice Address - Street 1:5555 W 58TH ST
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:KS
Practice Address - Zip Code:66202-2722
Practice Address - Country:US
Practice Address - Phone:913-432-2080
Practice Address - Fax:913-432-5183
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1270103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100098010Medicaid
24627016OtherBCBS OF KC