Provider Demographics
NPI:1366838070
Name:HESSELTINE, RYAN
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:HESSELTINE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10801 W 87TH ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66214-1657
Mailing Address - Country:US
Mailing Address - Phone:913-438-3000
Mailing Address - Fax:913-438-3003
Practice Address - Street 1:10801 W 87TH ST STE 300
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66214-1699
Practice Address - Country:US
Practice Address - Phone:913-438-3000
Practice Address - Fax:913-438-3003
Is Sole Proprietor?:No
Enumeration Date:2015-04-09
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1598237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist