1437358652 NPI number — NANCY G. POWERS, MD, LLC

Table of content: (NPI 1437358652)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437358652 NPI number — NANCY G. POWERS, MD, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NANCY G. POWERS, MD, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
BREASTFEEDING MEDICINE OF KANSAS
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437358652
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/17/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
509 N LORRAINE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WICHITA
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
67214-4836
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
316-304-2653
Provider Business Mailing Address Fax Number:
316-260-9127

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
509 N LORRAINE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WICHITA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67214-4836
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
316-304-2653
Provider Business Practice Location Address Fax Number:
316-260-9127
Provider Enumeration Date:
07/17/2007

Additional Information

Authorized Official

Authorized Official Last Name:
POWERS
Authorized Official First Name:
NANCY
Authorized Official Middle Name:
G
Authorized Official Title or Position:
MEMBER
Authorized Official Telephone Number:
316-304-2653

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X , with the licence number:  3822319 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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