Provider Demographics
NPI:1851403323
Name:STUBBLEFIELD, ERIN LACI (DC DOCTOR OF CHIROPR)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:LACI
Last Name:STUBBLEFIELD
Suffix:
Gender:F
Credentials:DC DOCTOR OF CHIROPR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10850 LOWELL AVE
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-1613
Mailing Address - Country:US
Mailing Address - Phone:913-234-0700
Mailing Address - Fax:
Practice Address - Street 1:10850 LOWELL AVE
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-1613
Practice Address - Country:US
Practice Address - Phone:913-234-0700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038010660111N00000X
KS0105319111N00000X
MO2010013354111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL743186253OtherEIN