Healthcare Provider Details

I. General information

NPI: 1609704824
Provider Name (Legal Business Name): BRITTA K MAXWELL PNP-AC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2026
Last Update Date: 05/09/2026
Certification Date: 05/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 SWEETWATER RD
MAIZE KS
67101-8110
US

IV. Provider business mailing address

402 SWEETWATER RD
MAIZE KS
67101-8110
US

V. Phone/Fax

Practice location:
  • Phone: 316-640-2052
  • Fax:
Mailing address:
  • Phone: 316-640-2052
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0222X
TaxonomyCritical Care Pediatric Nurse Practitioner
License Number5385250092
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: