Healthcare Provider Details

I. General information

NPI: 1588072557
Provider Name (Legal Business Name): DANICA WHEELER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DANICA SORIA APRN

II. Dates (important events)

Enumeration Date: 07/23/2014
Last Update Date: 05/08/2020
Certification Date: 05/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

507 E 16TH ST SUITE 1
WELLINGTON KS
67152-2805
US

IV. Provider business mailing address

507 E 16TH ST SUITE 1
WELLINGTON KS
67152-2805
US

V. Phone/Fax

Practice location:
  • Phone: 620-326-3301
  • Fax: 620-326-7086
Mailing address:
  • Phone: 620-326-3301
  • Fax: 620-326-7086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberTMP149369
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: