Healthcare Provider Details

I. General information

NPI: 1295471605
Provider Name (Legal Business Name): SHERRIE R LENOX NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2022
Last Update Date: 09/17/2024
Certification Date: 09/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3343 W CENTRAL AVE
WICHITA KS
67203-4917
US

IV. Provider business mailing address

1936 N NORTHRIDGE ST
ANDOVER KS
67002-8496
US

V. Phone/Fax

Practice location:
  • Phone: 316-260-4110
  • Fax: 316-351-5731
Mailing address:
  • Phone: 720-612-0610
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN-0140846
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number14-164163-052
License Number StateKS
# 3
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number53-83528-052
License Number StateKS
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number997733
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: