Provider Demographics
NPI:1245682764
Name:LANFERMANN, DANIELLE ELIZABETH (DPT, ATC)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:ELIZABETH
Last Name:LANFERMANN
Suffix:
Gender:F
Credentials:DPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 SWIFT AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-3426
Mailing Address - Country:US
Mailing Address - Phone:816-474-8877
Mailing Address - Fax:816-474-8878
Practice Address - Street 1:9151 NE 81ST TER
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64158-1294
Practice Address - Country:US
Practice Address - Phone:816-415-4971
Practice Address - Fax:816-415-8270
Is Sole Proprietor?:No
Enumeration Date:2016-07-08
Last Update Date:2017-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016023768225100000X
KS11-05392225100000X
KS24-007732255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer