Provider Demographics
NPI:1740927136
Name:REDIFER, DELANEY KAY (PT)
Entity type:Individual
Prefix:
First Name:DELANEY
Middle Name:KAY
Last Name:REDIFER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:DELANEY
Other - Middle Name:KAY
Other - Last Name:HANAGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1640 E TALL TREE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:DERBY
Mailing Address - State:KS
Mailing Address - Zip Code:67037-2000
Mailing Address - Country:US
Mailing Address - Phone:316-788-1825
Mailing Address - Fax:
Practice Address - Street 1:1640 E TALL TREE RD STE 200
Practice Address - Street 2:
Practice Address - City:DERBY
Practice Address - State:KS
Practice Address - Zip Code:67037-2000
Practice Address - Country:US
Practice Address - Phone:316-788-1825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-17
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-06972225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist