Prairie Star Family Practice, P.a.

NPI 1003929001 - Family Medicine - 207Q00000X

NPI Details
NPI 1003929001
Enumeration Date 08/16/2006
Last Updated 06/15/2010
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name JENNIFER JENNIFER
Position OWNER/PRESIDENT
Phone (785) 434-2622
Fax (785) 434-2577
Practice Location
1210 N. WASHINGTON, CLINIC B
PLAINVILLE KS, 67663-1632, US
Phone (785) 434-2622
Fax (785) 434-2577
Business Location
1210 N. WASHINGTON, CLINIC B
P.O. BOX 407
PLAINVILLE KS, 67663-0407, US
Phone (785) 434-2622
Fax (785) 434-2577
Toxanomy
Taxonomy Code 207Q00000X
License State Kansas
License Number 04-28262
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According to our database, Prairie Star Family Practice, P.a. NPI is 1003929001, taxonomy code is 207Q00000X and license number is 04-28262, license state is located at Kansas. Prairie Star Family Practice, P.a. physically located at 1210 N. Washington, Clinic B, Plainville KS, 67663-1632. NPI Number 1033115704 has the healthcare provider type.

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1003929001 NPI number is provided on an as is basis without warranty of any kind. 1003929001 is maintained by the National Plan & Provider Enumeration System. The contents of Prairie Star Family Practice, P.a. are for informational purposes only.