Healthcare Provider Details

I. General information

NPI: 1740090745
Provider Name (Legal Business Name): OCEAN MARIAH PRICE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2025
Last Update Date: 07/29/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 N HILLSIDE ST
WICHITA KS
67214-4976
US

IV. Provider business mailing address

1031 E SPLITWOOD WAY ST
DERBY KS
67037-8783
US

V. Phone/Fax

Practice location:
  • Phone: 316-765-5092
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License Number13139929061
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number5384588061
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: