Provider Demographics
NPI:1790088565
Name:LIEPKE, LINDY
Entity type:Individual
Prefix:
First Name:LINDY
Middle Name:
Last Name:LIEPKE
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 1:1301 TULLISON RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-2640
Mailing Address - Country:US
Mailing Address - Phone:816-768-6054
Mailing Address - Fax:
Practice Address - Street 1:1301 TULLISON RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-2640
Practice Address - Country:US
Practice Address - Phone:816-768-6054
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-16
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2630225100000X
MN8661225100000X
OR5434225100000X
FL28326225100000X
MO2005029648225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist