Healthcare Provider Details

I. General information

NPI: 1447140280
Provider Name (Legal Business Name): ELIZABETH MARKEY CHENOWETH FNP STUDENT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2025
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5900 SE 60TH ST
GALENA KS
66739-6122
US

IV. Provider business mailing address

5900 SE 60TH ST
GALENA KS
66739-6122
US

V. Phone/Fax

Practice location:
  • Phone: 417-291-4025
  • Fax:
Mailing address:
  • Phone: 417-291-4025
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number53-85688-052
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: