Provider Demographics
NPI:1881979052
Name:FLINT HILLS NEUROPSYCHOLOGY, LLC
Entity type:Organization
Organization Name:FLINT HILLS NEUROPSYCHOLOGY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:A
Authorized Official - Last Name:DURRETT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:785-236-1180
Mailing Address - Street 1:2505 ANDERSON AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-2853
Mailing Address - Country:US
Mailing Address - Phone:785-236-1180
Mailing Address - Fax:785-789-4048
Practice Address - Street 1:2505 ANDERSON AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-2853
Practice Address - Country:US
Practice Address - Phone:785-236-1180
Practice Address - Fax:785-789-4048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-19
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1994103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KA2351Medicare PIN