Healthcare Provider Details

I. General information

NPI: 1720726631
Provider Name (Legal Business Name): PROF. JENIFER MARIE NEMECHEK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2022
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 E KANSAS AVE
GARDEN CITY KS
67846-5805
US

IV. Provider business mailing address

1406 GRANDVIEW DR E
GARDEN CITY KS
67846-8659
US

V. Phone/Fax

Practice location:
  • Phone: 620-640-8762
  • Fax:
Mailing address:
  • Phone: 620-640-8762
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number1-13684
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: