Healthcare Provider Details

I. General information

NPI: 1023089018
Provider Name (Legal Business Name): MARIA M ILARDI ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 09/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 MAINE ST STE A
LAWRENCE KS
66044-1368
US

IV. Provider business mailing address

1311 WAKARUSA DR STE 2117
LAWRENCE KS
66049-4775
US

V. Phone/Fax

Practice location:
  • Phone: 785-843-9192
  • Fax: 785-843-6744
Mailing address:
  • Phone: 785-843-9192
  • Fax: 785-843-6744

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number74626
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: