Provider Demographics
NPI:1942033436
Name:HEARTLAND HEARING CARE
Entity type:Organization
Organization Name:HEARTLAND HEARING CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELLI
Authorized Official - Middle Name:
Authorized Official - Last Name:KERNAN
Authorized Official - Suffix:
Authorized Official - Credentials:BC-HIS
Authorized Official - Phone:573-756-0555
Mailing Address - Street 1:1325 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63640-7641
Mailing Address - Country:US
Mailing Address - Phone:573-756-0555
Mailing Address - Fax:573-756-0556
Practice Address - Street 1:1325 MAPLE ST
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:MO
Practice Address - Zip Code:63640-7641
Practice Address - Country:US
Practice Address - Phone:573-756-0555
Practice Address - Fax:573-756-0556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-21
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty