Provider Demographics
NPI:1780745331
Name:INNES, LIANNE L (OD)
Entity type:Individual
Prefix:DR
First Name:LIANNE
Middle Name:L
Last Name:INNES
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:215D NE ENGLEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64118-4586
Mailing Address - Country:US
Mailing Address - Phone:816-454-3937
Mailing Address - Fax:816-459-7282
Practice Address - Street 1:215D NE ENGLEWOOD RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64118-4586
Practice Address - Country:US
Practice Address - Phone:816-454-3937
Practice Address - Fax:816-459-7282
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006034246152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist