| NPI | 1174657225 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANNINE ANDERSON Owner 316-440-4060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: KS 74510) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2020-08-22 |