Provider Demographics
NPI:1558598219
Name:ROBINSON, KRISTY KAY (PTA)
Entity Type:Individual
Prefix:
First Name:KRISTY
Middle Name:KAY
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:KRISTY
Other - Middle Name:KAY
Other - Last Name:KENNEDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:6405 METCALF AVE
Mailing Address - Street 2:SUITE 220
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66202-3931
Mailing Address - Country:US
Mailing Address - Phone:913-831-2721
Mailing Address - Fax:913-384-0127
Practice Address - Street 1:1931 BURLINGTON ST
Practice Address - Street 2:
Practice Address - City:NORTH KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-3407
Practice Address - Country:US
Practice Address - Phone:913-831-2721
Practice Address - Fax:913-384-0127
Is Sole Proprietor?:No
Enumeration Date:2009-06-19
Last Update Date:2009-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003019568225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant