Provider Demographics
NPI:1568517571
Name:HINNERICHS, JOANN L (DC)
Entity Type:Individual
Prefix:DR
First Name:JOANN
Middle Name:L
Last Name:HINNERICHS
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 1:8105 WORNALL ROAD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-5805
Mailing Address - Country:US
Mailing Address - Phone:816-361-8105
Mailing Address - Fax:
Practice Address - Street 1:8105 WORNALL ROAD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-5805
Practice Address - Country:US
Practice Address - Phone:816-361-8105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO005024111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
10568026OtherBCBS
0001662Medicare ID - Type Unspecified