Provider Demographics
NPI:1851418479
Name:TIMMERMEYER, KRISTINE MARIE
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:MARIE
Last Name:TIMMERMEYER
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 1:9411 N OAK TRFY
Mailing Address - Street 2:SUITE LL1
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64155-2233
Mailing Address - Country:US
Mailing Address - Phone:816-436-7072
Mailing Address - Fax:816-436-2743
Practice Address - Street 1:2900 CLAY EDWARDS DR
Practice Address - Street 2:
Practice Address - City:NORTH KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-3221
Practice Address - Country:US
Practice Address - Phone:816-346-7400
Practice Address - Fax:816-346-7404
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO002879225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist