Provider Demographics
NPI:1518343441
Name:FARLEY, KAITLIN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:KAITLIN
Middle Name:
Last Name:FARLEY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15107 W 83RD TER
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66219-1545
Mailing Address - Country:US
Mailing Address - Phone:913-488-0244
Mailing Address - Fax:816-222-0679
Practice Address - Street 1:8340 MISSION RD STE 103
Practice Address - Street 2:
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66206-1362
Practice Address - Country:US
Practice Address - Phone:913-213-3531
Practice Address - Fax:402-280-2210
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-03
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3499225100000X
KS11-05444225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS11-05444OtherSTATE BOARD OF HEALING ARTS