Healthcare Provider Details

I. General information

NPI: 1689832305
Provider Name (Legal Business Name): MS. ERICA NICOLE VOSHELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/29/2008
Last Update Date: 05/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 MICHIGAN ST APT D
WELLINGTON KS
67152-4639
US

IV. Provider business mailing address

1310 MICHIGAN CT APT D
WELLINGTON KS
67152
US

V. Phone/Fax

Practice location:
  • Phone: 316-737-4289
  • Fax:
Mailing address:
  • Phone: 316-737-4289
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberKO1 80 9031
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: