Provider Demographics
NPI:1124304704
Name:CURTIS YEAGER, STACEY RENEE (PT)
Entity type:Individual
Prefix:MRS
First Name:STACEY
Middle Name:RENEE
Last Name:CURTIS YEAGER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15009 W 71ST TER
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66216-4012
Mailing Address - Country:US
Mailing Address - Phone:913-232-8112
Mailing Address - Fax:
Practice Address - Street 1:SPRINT ON SITE HEALTH CTR
Practice Address - Street 2:6400 SPRINT PARKWAY
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66251
Practice Address - Country:US
Practice Address - Phone:913-315-6432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-27
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-03898225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist