Provider Demographics
NPI:1225071913
Name:HEIMAN, KRISTINA RAE (DC)
Entity Type:Individual
Prefix:DR
First Name:KRISTINA
Middle Name:RAE
Last Name:HEIMAN
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 1:514 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SENECA
Mailing Address - State:KS
Mailing Address - Zip Code:66538-1928
Mailing Address - Country:US
Mailing Address - Phone:785-336-6222
Mailing Address - Fax:785-336-6224
Practice Address - Street 1:514 MAIN ST
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:KS
Practice Address - Zip Code:66538-1928
Practice Address - Country:US
Practice Address - Phone:785-336-6222
Practice Address - Fax:785-336-6224
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-04900111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200550600AMedicaid
KS0000062496OtherBCBS