MEDICARE: MRS. DONNA G ADES ARNP

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	363LF0000X	Family Nurse Practitioner	44398ARNP	KS

General Provider Information

NPI Number	:	1649265836
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DONNA G ADES ARNP

Provider Business Mailing Address
First Line	:	PO BOX 48514
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67201-8514
Country	:	US
Telephone Number	:	913-248-9693
Fax Number	:	913-248-9383

Provider Business Practice Location Address
First Line	:	700 W CENTRAL AVE
Second Line	:	SUITE 206
City	:	EL DORADO
State	:	KS
Zip	:	67042-2184
Country	:	US
Telephone Number	:	316-320-3100
Fax Number	:	316-321-2188

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

Provider Enumeration Date	:	09/14/2005
Last Update Date	:	12/17/2007

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