Provider Demographics
NPI:1689845711
Name:SCHMIDT, KELLY R (AUD)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:R
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:R
Other - Last Name:BARROW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:20375 W 151ST ST
Mailing Address - Street 2:SUITE 106
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-5306
Mailing Address - Country:US
Mailing Address - Phone:913-764-2737
Mailing Address - Fax:913-764-7502
Practice Address - Street 1:20375 W 151ST ST
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-5306
Practice Address - Country:US
Practice Address - Phone:913-764-2737
Practice Address - Fax:913-764-7502
Is Sole Proprietor?:No
Enumeration Date:2008-03-17
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2118231H00000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter