Healthcare Provider Details

I. General information

NPI: 1639178015
Provider Name (Legal Business Name): CHERYL M DULTMEIER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 03/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

634 SW MULVANE ST SUITE 209
TOPEKA KS
66606-1678
US

IV. Provider business mailing address

DEPT CH 14389
PALATINE IL
60055-4389
US

V. Phone/Fax

Practice location:
  • Phone: 785-295-5330
  • Fax: 785-295-5355
Mailing address:
  • Phone: 785-295-8108
  • Fax: 785-231-5991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number44923
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: