Kimberly N Hackney
Pediatrician Pediatric Emergency Doctor
300 Winding Woods Dr Ste 120
O Fallon
, Missouri 63366-4772
Kimberly N Hackney
Pediatrician Pediatric Emergency Doctor
300 Winding Woods Dr Ste 120
O Fallon
, Missouri 63366-4772
(636) 978-7902
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About
Features
Specialties
- Pediatrician
- Pediatric Emergency Doctor
Languages spoken
- English
Location
First Address
- Kimberly N Hackney
- 300 Winding Woods Dr Ste 120
- O Fallon, MO
- Zip : 63366-4772
- Phone : (636) 978-7902
Second Address
- Kimberly N Hackney
- 300 Winding Woods Dr Ste 120
- O Fallon, MO
- Zip : 63366-4772
- Phone : (636) 978-7902
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FAQs
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Is Kimberly N Hackney accepting new patients?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 208000000X | Pediatrician | 2010037113 | MO |
| N | 2080P0204X | Pediatric Emergency Doctor | 05-35901 | KS |
| N | 2080P0204X | Pediatric Emergency Doctor | 2010037113 | MO |
National Provider Identifier
| NPI | 1083842454 |
|---|---|
| Provider Name | Kimberly N Hackney |
| First Address | O Fallon, MO 63366-4772 |
| Second Address | O Fallon, MO 63366-4772 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 24/06/2009 |
| Last Update Date | 28/11/2017 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1083842454 | (05) | MO |
| P01296531 | RAILROAD MEDICARE (01) | MO |
| PAYEE 1 | ILLINOIS MEDICAL ASSISTANCE PROGRAM (01) | IL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.