Healthcare Provider Details

I. General information

NPI: 1437154408
Provider Name (Legal Business Name): KAREN S WHEELER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2005
Last Update Date: 06/02/2020
Certification Date: 06/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 CORONADO DR
HUTCHINSON KS
67502-2258
US

IV. Provider business mailing address

910 CORONADO DR
HUTCHINSON KS
67502-2258
US

V. Phone/Fax

Practice location:
  • Phone: 620-259-7022
  • Fax: 620-259-7029
Mailing address:
  • Phone: 620-259-7022
  • Fax: 620-259-7029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number44775
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number44775
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number44775
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: