Provider Demographics
NPI:1255594644
Name:FEREBEE, ROBERT WALKER
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:WALKER
Last Name:FEREBEE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10568 CENTURY LN
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66215-2272
Mailing Address - Country:US
Mailing Address - Phone:913-307-9974
Mailing Address - Fax:
Practice Address - Street 1:10568 CENTURY LN
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66215-2272
Practice Address - Country:US
Practice Address - Phone:913-307-9974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-07
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSK01808100385HR2060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child