Brenna Marie Kietzmann

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

14-03370 Issued in KS

Practice address

1198 Front St
Tonganoxie, KS 66086-9707

Phone

(913) 417-7400

Fax

(913) 369-2836

NPI assigned

Sep 11, 2019

Last updated

Sep 11, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1568160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568160000000",
    "number": "1699324665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20650 PARALLEL RD",
            "city": "TONGANOXIE",
            "state": "KS",
            "postal_code": "660865348",
            "telephone_number": "913-626-1886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1198 FRONT ST",
            "city": "TONGANOXIE",
            "state": "KS",
            "postal_code": "660869707",
            "telephone_number": "913-417-7400",
            "fax_number": "913-369-2836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIETZMANN",
        "first_name": "BRENNA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-11",
        "last_updated": "2019-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "KS",
            "license": "14-03370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David H Jaeger, D.D.S.
• JRR, DDS, LLC
• Aryn Kamerer
• Kelsey Kearns
• Brittany Keever
• Samantha Kirkwood
• Carrie Koch
• Maria Korjenevski
• Tara Krajewski
• Cynthia Kraus

• Physical Therapy Assistant in Tonganoxie, KS
• Providers in Tonganoxie, KS by specialty
• Physical Therapy Assistant in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.