Healthcare Provider Details

I. General information

NPI: 1336923523
Provider Name (Legal Business Name): SASHA MORALES RAMIREZ APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SASHA MORALES

II. Dates (important events)

Enumeration Date: 08/21/2023
Last Update Date: 10/11/2023
Certification Date: 10/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 E. SPRUCE
GARDEN CITY KS
67846
US

IV. Provider business mailing address

724 CENTER ST
GARDEN CITY KS
67846-5929
US

V. Phone/Fax

Practice location:
  • Phone: 620-275-3030
  • Fax:
Mailing address:
  • Phone: 316-371-5853
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5382451
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number82451
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: