Provider Demographics
NPI:1841742921
Name:EBERT, TRICIA KATHERINE (APRN-PMHNP-BC)
Entity type:Individual
Prefix:
First Name:TRICIA
Middle Name:KATHERINE
Last Name:EBERT
Suffix:
Gender:F
Credentials:APRN-PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12641 ANTIOCH RD STE 1006
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66213-1701
Mailing Address - Country:US
Mailing Address - Phone:913-421-8422
Mailing Address - Fax:913-421-8423
Practice Address - Street 1:8400 W 110TH ST STE 270
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-2468
Practice Address - Country:US
Practice Address - Phone:913-346-6302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-25
Last Update Date:2025-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-83926-082363LP0808X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100098080AMedicaid
KS100098080COtherSED WAIVER
KS100098080AMedicaid