Healthcare Provider Details

I. General information

NPI: 1124085964
Provider Name (Legal Business Name): CONSTANCE DENISE HERMRECK ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 02/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 SW GAGE BLVD VA EASTERN KANSAS
TOPEKA KS
66622
US

IV. Provider business mailing address

3439 THOMAS ROAD
WELLSVILLE KS
66092
US

V. Phone/Fax

Practice location:
  • Phone: 785-350-3111
  • Fax: 785-350-4535
Mailing address:
  • Phone: 785-250-1803
  • Fax: 785-350-4535

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP44572
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: