| NPI | 1285026351 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCI BACON Business Manager/Billing Specialist 316-722-2138 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 46278) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 76470) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KS 80145) | |
| Enumeration Date | 2015-02-26 |
| Last Update Date | 2023-07-12 |