Healthcare Provider Details

I. General information

NPI: 1295500833
Provider Name (Legal Business Name): JODY BUCHANAN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2023
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
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

14718 SW CLOVER LN
ROSE HILL KS
67133-8370
US

V. Phone/Fax

Practice location:
  • Phone: 316-247-2234
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number53-82669-031
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: