Provider Demographics
NPI:1043257447
Name:SUMNER, KIMBERLY MICHEL (MSPT)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:MICHEL
Last Name:SUMNER
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:MICHEL
Other - Last Name:HAMDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPT
Mailing Address - Street 1:6400 GLENWOOD
Mailing Address - Street 2:SUITE 111
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66202
Mailing Address - Country:US
Mailing Address - Phone:913-831-2721
Mailing Address - Fax:913-384-0127
Practice Address - Street 1:16018 W. 65TH STREET
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66217
Practice Address - Country:US
Practice Address - Phone:913-815-6677
Practice Address - Fax:913-248-3256
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2019-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000174344225100000X
KS11-03395225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist