MEDICARE: MRS. KIMBERLY A DANSEL PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	T00865	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	T00865	OTHER	KS	KANSAS STATE LICENSE

General Provider Information

NPI Number	:	1235236621
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KIMBERLY A DANSEL PA-C

Provider Business Mailing Address
First Line	:	PO BOX 310
Second Line	:
City	:	SHARON SPRINGS
State	:	KS
Zip	:	67758-0310
Country	:	US
Telephone Number	:	785-852-4230
Fax Number	:	785-852-4364

Provider Business Practice Location Address
First Line	:	504 E 6TH
Second Line	:
City	:	SHARON SPRINGS
State	:	KS
Zip	:	67758-0310
Country	:	US
Telephone Number	:	785-852-4230
Fax Number	:	785-852-4364

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	02/14/2014

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