Healthcare Provider Details

I. General information

NPI: 1255746384
Provider Name (Legal Business Name): KRISTIN L GOETZ APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2014
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 S LINCOLN ST
ARLINGTON KS
67514-1431
US

IV. Provider business mailing address

100 S LINCOLN ST
ARLINGTON KS
67514-1431
US

V. Phone/Fax

Practice location:
  • Phone: 620-860-9490
  • Fax: 316-395-1139
Mailing address:
  • Phone: 620-860-9490
  • Fax: 316-395-1139

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number53-76274-041
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number13-109121-041
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: