Provider Demographics
NPI:1497215024
Name:HEARNS, KIANNA MI
Entity Type:Individual
Prefix:
First Name:KIANNA
Middle Name:MI
Last Name:HEARNS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7206 N BLUEGRASS ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99217-8750
Mailing Address - Country:US
Mailing Address - Phone:206-914-2809
Mailing Address - Fax:
Practice Address - Street 1:7206 N BLUEGRASS ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99217-8750
Practice Address - Country:US
Practice Address - Phone:206-914-2809
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-20
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst