Healthcare Provider Details

I. General information

NPI: 1699951129
Provider Name (Legal Business Name): JOHN REXWINKLE D.C., CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2008
Last Update Date: 11/12/2024
Certification Date: 11/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1902 S US HIGHWAY 59
PARSONS KS
67357-4948
US

IV. Provider business mailing address

200 LEAWOOD DR
PARSONS KS
67357-3459
US

V. Phone/Fax

Practice location:
  • Phone: 620-421-4881
  • Fax:
Mailing address:
  • Phone: 918-409-4659
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number146673
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: