Individual
LYNNE E KALLENBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
12140 NALL AVE, STE 100, OVERLAND PARK, KS 66209-2503
(913) 451-8500
(913) 451-8575
Mailing address
12639 OLD TESSON RD, STE 100, SAINT LOUIS, MO 63128-2786
(913) 451-8500
(913) 451-8575
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
04-30715
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100066940B
—
KS
05
—
207217308
—
MO
01
—
35463015
BCBS KC
MO
01
—
927267
FIRSTGUARD
KS
Enumeration date
09/05/2006
Last updated
11/04/2016
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