Provider Demographics
NPI:1093851818
Name:WHITAKER, BRANDI (DC)
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:
Last Name:WHITAKER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2627 BURLINGTON ST
Mailing Address - Street 2:
Mailing Address - City:NORTH KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-3012
Mailing Address - Country:US
Mailing Address - Phone:816-268-1000
Mailing Address - Fax:816-268-1001
Practice Address - Street 1:2627 BURLINGTON ST
Practice Address - Street 2:
Practice Address - City:NORTH KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-3012
Practice Address - Country:US
Practice Address - Phone:816-268-1000
Practice Address - Fax:816-268-1001
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005004106111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
1538304654OtherMEDICARE
MO000E513Medicare ID - Type Unspecified