Healthcare Provider Details

I. General information

NPI: 1831295476
Provider Name (Legal Business Name): MICKI K ZENGER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2337 G ST
BELLEVILLE KS
66935-2463
US

IV. Provider business mailing address

2337 G ST
BELLEVILLE KS
66935-2463
US

V. Phone/Fax

Practice location:
  • Phone: 785-527-2217
  • Fax: 785-527-5929
Mailing address:
  • Phone: 785-527-2217
  • Fax: 785-527-5929

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number44062
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: