Healthcare Provider Details

I. General information

NPI: 1689100364
Provider Name (Legal Business Name): CHANTELL PLANK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2017
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

217 SOUTHWIND PL STE 101
MANHATTAN KS
66503-3159
US

IV. Provider business mailing address

517 SOUTHWIND PLACE SUITE 101
MANHATTAN KS
66503
US

V. Phone/Fax

Practice location:
  • Phone: 785-369-1158
  • Fax:
Mailing address:
  • Phone: 785-569-0202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: