Provider Demographics
NPI:1164280335
Name:HAYNIE, EMMA RACHELLE (DC)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:RACHELLE
Last Name:HAYNIE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:EMMA
Other - Middle Name:RACHELLE
Other - Last Name:HAYNIE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:715 HIGH ST STE B
Mailing Address - Street 2:
Mailing Address - City:BALDWIN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66006-3015
Mailing Address - Country:US
Mailing Address - Phone:913-349-2037
Mailing Address - Fax:
Practice Address - Street 1:715 HIGH ST STE B
Practice Address - Street 2:
Practice Address - City:BALDWIN CITY
Practice Address - State:KS
Practice Address - Zip Code:66006-3015
Practice Address - Country:US
Practice Address - Phone:913-349-2037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-06305111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor