Provider Demographics
NPI:1497812382
Name:GILKISON, JENNIFER LYNN (DC)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:LYNN
Last Name:GILKISON
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 1:672 SE BAYBERRY LN
Mailing Address - Street 2:SUITE 105
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64063-4354
Mailing Address - Country:US
Mailing Address - Phone:816-554-7246
Mailing Address - Fax:816-554-1829
Practice Address - Street 1:672 SE BAYBERRY LN
Practice Address - Street 2:SUITE 105
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64063-4354
Practice Address - Country:US
Practice Address - Phone:816-554-7246
Practice Address - Fax:816-554-1829
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001030193111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor