Healthcare Provider Details

I. General information

NPI: 1063993533
Provider Name (Legal Business Name): AQUINS WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2018
Last Update Date: 08/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7011 W 121ST ST STE 105
OVERLAND PARK KS
66209
US

IV. Provider business mailing address

7011 W 121ST ST STE 105
OVERLAND PARK KS
66209-2029
US

V. Phone/Fax

Practice location:
  • Phone: 913-601-5220
  • Fax: 913-273-0649
Mailing address:
  • Phone: 913-602-9427
  • Fax: 913-273-0649

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number77799
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code364SP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
License Number77799
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number77799
License Number StateKS
# 4
Primary TaxonomyN
Taxonomy Code364SP0811X
TaxonomyChronically Ill Psychiatric/Mental Health Clinical Nurse Specialist
License Number77799
License Number StateKS
# 5
Primary TaxonomyN
Taxonomy Code364SP0812X
TaxonomyCommunity Psychiatric/Mental Health Clinical Nurse Specialist
License Number77799
License Number StateKS
# 6
Primary TaxonomyN
Taxonomy Code364SP0813X
TaxonomyGeropsychiatric Psychiatric/Mental Health Clinical Nurse Specialist
License Number77799
License Number StateKS

VIII. Authorized Official

Name: MS. QUEEN B. USI
Title or Position: PSYCHIATRIC NURSE PRACTITIONER
Credential: MSN, APRN, PMHNP-BC
Phone: 913-602-9427