Provider Demographics
NPI:1992731145
Name:ELLERBECK, KATHRYN ANNE (MD)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:ANNE
Last Name:ELLERBECK
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Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 411851
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64141-1851
Mailing Address - Country:US
Mailing Address - Phone:913-384-3546
Mailing Address - Fax:913-588-5916
Practice Address - Street 1:3901 RAINBOW BLVD.-MAILSTOP 4003
Practice Address - Street 2:CENTER FOR CHILD HEALTH AND DEVELOPMENT CENTER
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-0001
Practice Address - Country:US
Practice Address - Phone:913-588-5781
Practice Address - Fax:913-588-5916
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2014-07-15
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Provider Licenses
StateLicense IDTaxonomies
KS04-284392080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics