Provider Demographics
NPI:1881746436
Name:HALSEY, GINA (LAC, DIPLOM (NCCAOM))
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:HALSEY
Suffix:
Gender:F
Credentials:LAC, DIPLOM (NCCAOM)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2512 W 6TH ST STE C
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66049-2441
Mailing Address - Country:US
Mailing Address - Phone:785-856-6789
Mailing Address - Fax:785-856-4050
Practice Address - Street 1:2512 W 6TH ST STE C
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66049
Practice Address - Country:US
Practice Address - Phone:785-856-6789
Practice Address - Fax:785-856-4050
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC5556171100000X
KS2300043171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist