Healthcare Provider Details

I. General information

NPI: 1346988227
Provider Name (Legal Business Name): CHEYENNE LERAY ARMBRUSTER-WAHRMAN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHEYENNE LERAY ARMBRUSTER

II. Dates (important events)

Enumeration Date: 05/21/2022
Last Update Date: 10/04/2022
Certification Date: 10/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1210 N WASHINGTON ST
PLAINVILLE KS
67663-1632
US

IV. Provider business mailing address

702 N JEFFERSON ST
PLAINVILLE KS
67663-1612
US

V. Phone/Fax

Practice location:
  • Phone: 785-434-2622
  • Fax:
Mailing address:
  • Phone: 785-259-5529
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1502670
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: