Organization · NPI-2
Advanced Clinical Consultants Of Kansas LLC
Nurse Practitioner, Family · Wichita, KS
NPI number1205522661
StatusActive
Last updated in NPPESApr 17, 2023
Details
- NPI
- 1205522661
- Entity type
- Organization (NPI-2)
- Legal business name
- Advanced Clinical Consultants Of Kansas LLC
- Organization subpart
- No
- Enumeration date
- Apr 17, 2023
- Certification date
- Apr 17, 2023
- Last updated
- Apr 17, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | – | – | Yes |
Practice location
5901 W Driftwood StWichita, KS 67205-5265
Phone 316-619-0411
Mailing address
5901 W Driftwood StWichita, KS 67205-5265
Phone 316-619-0411
Authorized official
Lauren Shelby Ewertz
Owner/Aprn
3166190411
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