Healthcare Provider Details

I. General information

NPI: 1871341982
Provider Name (Legal Business Name): MACKENZIE SUZANNE STINNETT DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2024
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6505 N PROSPECT AVE STE 700
GLADSTONE MO
64119-1570
US

IV. Provider business mailing address

6505 N PROSPECT AVE STE 700
GLADSTONE MO
64119-1570
US

V. Phone/Fax

Practice location:
  • Phone: 816-454-3399
  • Fax: 816-454-3012
Mailing address:
  • Phone: 816-454-3399
  • Fax: 816-454-3012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2024016279
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: