Healthcare Provider Details

I. General information

NPI: 1053275008
Provider Name (Legal Business Name): LUCY CHINASA CHIMEZIE PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 S SANTA FE AVE
SALINA KS
67401-4144
US

IV. Provider business mailing address

400 S SANTA FE AVE
SALINA KS
67401-4144
US

V. Phone/Fax

Practice location:
  • Phone: 785-452-7000
  • Fax:
Mailing address:
  • Phone: 785-452-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number53-84702-021
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: