Provider Demographics
NPI:1386655215
Name:HANEY, ROCHELLE ELIEEN (DC)
Entity Type:Individual
Prefix:
First Name:ROCHELLE
Middle Name:ELIEEN
Last Name:HANEY
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 1:105 W SANTA FE AVE
Mailing Address - Street 2:
Mailing Address - City:ULYSSES
Mailing Address - State:KS
Mailing Address - Zip Code:67880-2528
Mailing Address - Country:US
Mailing Address - Phone:620-353-1747
Mailing Address - Fax:620-356-1746
Practice Address - Street 1:105 W SANTA FE AVE
Practice Address - Street 2:
Practice Address - City:ULYSSES
Practice Address - State:KS
Practice Address - Zip Code:67880-2528
Practice Address - Country:US
Practice Address - Phone:620-353-1747
Practice Address - Fax:620-356-1746
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS4804111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS23704OtherBCBS