Provider Demographics
NPI:1265190482
Name:KINNEY, BIANCA (CLMP)
Entity type:Individual
Prefix:
First Name:BIANCA
Middle Name:
Last Name:KINNEY
Suffix:
Gender:F
Credentials:CLMP
Other - Prefix:
Other - First Name:BIANCA
Other - Middle Name:
Other - Last Name:K. CLMP
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CLMP
Mailing Address - Street 1:4800 W 135TH ST STE 150
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66224-8717
Mailing Address - Country:US
Mailing Address - Phone:816-510-2202
Mailing Address - Fax:
Practice Address - Street 1:4800 W 135TH ST STE 150
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66224-8717
Practice Address - Country:US
Practice Address - Phone:816-510-2202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-05
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist