Provider Demographics
NPI:1316153216
Name:CONNER, KAREN RENAE (CCC-SLP)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:RENAE
Last Name:CONNER
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:RENAE
Other - Last Name:SCHMITENDORF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:PO BOX 188
Mailing Address - Street 2:
Mailing Address - City:LEAVENWORTH
Mailing Address - State:KS
Mailing Address - Zip Code:66048-0188
Mailing Address - Country:US
Mailing Address - Phone:913-651-1000
Mailing Address - Fax:913-651-3030
Practice Address - Street 1:3400 S 4TH TRAFFICWAY
Practice Address - Street 2:SUITE C
Practice Address - City:LEAVENWORTH
Practice Address - State:KS
Practice Address - Zip Code:66048-5012
Practice Address - Country:US
Practice Address - Phone:913-651-1000
Practice Address - Fax:913-651-3030
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2420235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS115847OtherBCBS OF KANSAS