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Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1134437411

Individual Registrant:
Gender: F
Not Sole Proprietor

Location and contact information for practice:
445 E 10TH ST  BAXTER SPRINGS, KS 66713-1614 US
Tel: 620-856-3469  Fax: 620-856-5330

Contact information for business:
445 E 10TH ST  BAXTER SPRINGS, KS 66713-1614 US
Tel: 620-856-3469  Fax: 620-856-5330

Registration Information:
NPI: 1134437411
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner

Legacy codes, insurance codes and state license numbers:



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