1780800052 NPI number — FIRST HAND SURGICAL ASSISTANTS LLC

Table of content: DR. TERESA MARIE WISNER DC (NPI 1386720597)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780800052 NPI number — FIRST HAND SURGICAL ASSISTANTS LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FIRST HAND SURGICAL ASSISTANTS 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:
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:
1780800052
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
13218 W 77TH PL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LENEXA
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66216-3014
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
913-248-8082
Provider Business Mailing Address Fax Number:
888-329-6432

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13218 W 77TH PL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LENEXA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66216-3014
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-248-8082
Provider Business Practice Location Address Fax Number:
888-329-6432
Provider Enumeration Date:
04/17/2007

Additional Information

Authorized Official

Authorized Official Last Name:
ZYCH
Authorized Official First Name:
LAURA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
913-248-8082

Provider Taxonomy Codes

  • Taxonomy code: 163WR0006X , with the licence number:  13-46067-062 , 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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