Healthcare Provider Details

I. General information

NPI: 1134442569
Provider Name (Legal Business Name): NANCY CISKEY N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/12/2010
Last Update Date: 03/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 REFORMATORY ST
HUTCHINSON KS
67501-3081
US

IV. Provider business mailing address

1524 BROOKWOOD DR
HUTCHINSON KS
67502-2614
US

V. Phone/Fax

Practice location:
  • Phone: 620-728-3216
  • Fax:
Mailing address:
  • Phone: 620-665-1003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number45501
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: