Provider Demographics
NPI:1245235308
Name:HENNES, KELLY (PT)
Entity type:Individual
Prefix:MISS
First Name:KELLY
Middle Name:
Last Name:HENNES
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 1:7721 SW 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66615-1215
Mailing Address - Country:US
Mailing Address - Phone:785-271-5533
Mailing Address - Fax:785-271-8818
Practice Address - Street 1:5220 SW 17TH
Practice Address - Street 2:SUITE 130
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66604-2459
Practice Address - Country:US
Practice Address - Phone:785-271-5533
Practice Address - Fax:785-271-8818
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-16
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-03250225100000X
2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
140418OtherBLUE CROSS
140418OtherBLUE CROSS