Healthcare Provider Details

I. General information

NPI: 1972650117
Provider Name (Legal Business Name): HEATHER M IANNELLI B.S., D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7830 CONNECTOR DR
FLORENCE KY
41042-1435
US

IV. Provider business mailing address

1898 ASHWOOD CIR
FT WRIGHT KY
41011-2602
US

V. Phone/Fax

Practice location:
  • Phone: 859-525-2994
  • Fax:
Mailing address:
  • Phone: 859-331-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4551
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number250274
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: