Healthcare Provider Details
I. General information
NPI: 1659178028
Provider Name (Legal Business Name): SAKURA HEALTH AND WELLNESS, PROFESSIONAL LIMITED LIABILITY COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/25/2025
Last Update Date: 02/25/2025
Certification Date: 02/25/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1224 N ANDOVER RD STE 300
ANDOVER KS
67002-9310
US
IV. Provider business mailing address
1224 N ANDOVER RD STE 300
ANDOVER KS
67002-9310
US
V. Phone/Fax
- Phone: 316-247-2234
- Fax: 316-206-4104
- Phone: 316-247-2234
- Fax: 316-206-4104
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 367A00000X |
| Taxonomy | Advanced Practice Midwife |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JAMIE
A
HARRINGTON
Title or Position: OWNER
Credential: APRN
Phone: 316-247-2234