Provider Demographics
NPI:1275651275
Name:ESSEN, JOAN E (DC)
Entity Type:Individual
Prefix:DR
First Name:JOAN
Middle Name:E
Last Name:ESSEN
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 1:11770 MANCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:DES PERES
Mailing Address - State:MO
Mailing Address - Zip Code:63131-4617
Mailing Address - Country:US
Mailing Address - Phone:636-825-0360
Mailing Address - Fax:636-825-0360
Practice Address - Street 1:11770 MANCHESTER RD
Practice Address - Street 2:
Practice Address - City:DES PERES
Practice Address - State:MO
Practice Address - Zip Code:63131-4617
Practice Address - Country:US
Practice Address - Phone:636-825-0360
Practice Address - Fax:636-825-0360
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2015-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001011183111N00000X, 171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO627977OtherUHC
MO144594OtherANTHEM BCBS
MO627977OtherUHC