Individual
MS. STACY KORRINE JIMENEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
18122 W 119TH ST, OLATHE, KS 66061-9532
(913) 730-1800
(913) 730-1804
Mailing address
18122 W 119TH ST, OLATHE, KS 66061-9532
(913) 730-1800
(913) 730-1804
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
01-05606
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50198021
BCBS PROVIDER #
KS
01
—
50415017
BCBS GROUP #
KS
Enumeration date
01/16/2014
Last updated
09/09/2020
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