Provider Demographics
NPI:1003659111
Name:BEEBE, KACIE (DPT)
Entity type:Individual
Prefix:
First Name:KACIE
Middle Name:
Last Name:BEEBE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11290 S BELMONT DR
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-7347
Mailing Address - Country:US
Mailing Address - Phone:913-433-4893
Mailing Address - Fax:
Practice Address - Street 1:10400 W 103RD ST STE 22
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66214-2664
Practice Address - Country:US
Practice Address - Phone:913-322-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-07639225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist