Healthcare Provider Details

I. General information

NPI: 1255267845
Provider Name (Legal Business Name): FORT HAYS STATE UNIVERSITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

600 PARK ST
HAYS KS
67601-4099
US

IV. Provider business mailing address

600 PARK ST
HAYS KS
67601-4099
US

V. Phone/Fax

Practice location:
  • Phone: 785-628-4405
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: KARMEN PORTER
Title or Position: CHAIR
Credential:
Phone: 800-578-7906