| NPI | 1366618084 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY D FENN CEO 316-722-4247 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: KS 0422530) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 44143) |
| Enumeration Date | 2008-05-02 |
| Last Update Date | 2012-06-04 |