Provider Demographics
NPI:1932191764
Name:EHRNMAN, KELLY M (RPT)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:M
Last Name:EHRNMAN
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9211 MOODY PARK DR
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-4928
Mailing Address - Country:US
Mailing Address - Phone:913-492-5254
Mailing Address - Fax:913-754-0365
Practice Address - Street 1:9211 MOODY PARK DR
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-4928
Practice Address - Country:US
Practice Address - Phone:913-492-5254
Practice Address - Fax:913-754-0365
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO01892225100000X
KS11 01638225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist