Healthcare Provider Details

I. General information

NPI: 1275642332
Provider Name (Legal Business Name): LUANN K HORCHEM APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 LOCUST ST
LA CROSSE KS
67548-9673
US

IV. Provider business mailing address

25000 AA RD PO BOX 187
RANSOM KS
67572-7213
US

V. Phone/Fax

Practice location:
  • Phone: 785-222-2545
  • Fax: 785-222-2868
Mailing address:
  • Phone: 785-731-2712
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number44054
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: