Provider Demographics
NPI:1639675119
Name:STRICKLAND, TEAH RAE
Entity Type:Individual
Prefix:MRS
First Name:TEAH
Middle Name:RAE
Last Name:STRICKLAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2103 N 7TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66101-1609
Mailing Address - Country:US
Mailing Address - Phone:816-924-9683
Mailing Address - Fax:
Practice Address - Street 1:2103 N 7TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66101
Practice Address - Country:US
Practice Address - Phone:816-924-9683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-03
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS82-4990624Medicaid