1326527987 NPI number — MRS. WENDI NICHOL ARMBRUSTER LAC

Table of content: MRS. WENDI NICHOL ARMBRUSTER LAC (NPI 1326527987)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326527987 NPI number — MRS. WENDI NICHOL ARMBRUSTER LAC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ARMBRUSTER
Provider First Name:
WENDI
Provider Middle Name:
NICHOL
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LAC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1326527987
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/14/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLBY
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
67701-0100
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
785-269-1033
Provider Business Mailing Address Fax Number:
785-462-6385

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
990 S RANGE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLBY
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67701-3509
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-269-1033
Provider Business Practice Location Address Fax Number:
785-462-6385
Provider Enumeration Date:
08/14/2018

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YA0400X , with the licence number:  496 , 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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