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NPI Code Detail

MEDICARE: GILLIAN KOHLHORST ARNP

MEDICARE: GILLIAN KOHLHORST 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
1207Q00000XFamily Medicine Physician44694KS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1160542OTHERKSBC/BS PROVIDER NUMBER

General Provider Information

NPI Number : 1699760389
Entity Type Code : Individual
Provider Name (Legal Business Name) : GILLIAN KOHLHORST ARNP
Provider Business Mailing Address
First Line : 712 SAINT JOHN ST
Second Line :
City : GARDEN CITY
State : KS
Zip : 67846-5128
Country : US
Telephone Number : 620-275-1766
Fax Number :
Provider Business Practice Location Address
First Line : 712 SAINT JOHN ST
Second Line :
City : GARDEN CITY
State : KS
Zip : 67846-5128
Country : US
Telephone Number : 620-275-1766
Fax Number : 620-275-4729
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/19/2005
Last Update Date : 12/28/2012

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Directions to “ GILLIAN KOHLHORST ARNP” Practice Location

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