Healthcare Provider Details

I. General information

NPI: 1689779258
Provider Name (Legal Business Name): COUNTY OF BARTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 09/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 KANSAS AVE
GREAT BEND KS
67530-4407
US

IV. Provider business mailing address

1300 KANSAS AVE
GREAT BEND KS
67530-4407
US

V. Phone/Fax

Practice location:
  • Phone: 620-793-1902
  • Fax: 620-793-1901
Mailing address:
  • Phone: 620-793-1902
  • Fax: 620-793-1901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number13031622111
License Number StateKS

VIII. Authorized Official

Name: MRS. LILLLIAN MARLENE AKINGS
Title or Position: ADMINISTRATOR
Credential: R.N.
Phone: 620-793-1902