Healthcare Provider Details

I. General information

NPI: 1215125372
Provider Name (Legal Business Name): PLAINSMEN HEALTH SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2007
Last Update Date: 05/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14000 23RD ST SUITE 1A
PERRY KS
66073-4046
US

IV. Provider business mailing address

PO BOX 221 14000 23RD STREET SUITE 1A
PERRY KS
66073-0221
US

V. Phone/Fax

Practice location:
  • Phone: 785-218-1694
  • Fax:
Mailing address:
  • Phone: 785-218-5077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number45960
License Number StateKS

VIII. Authorized Official

Name: MS. MARYPAT BLUM DWYER
Title or Position: PRESIDENT
Credential: ARNP
Phone: 785-218-1694