Healthcare Provider Details

I. General information

NPI: 1356789465
Provider Name (Legal Business Name): JOCELYN ROBIN ZAUCHE C-PNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2013
Last Update Date: 04/07/2021
Certification Date: 04/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 N. HILLSIDE
WICHITA KS
67214-4619
US

IV. Provider business mailing address

550 N. HILLSIDE
WICHITA KS
67214-4619
US

V. Phone/Fax

Practice location:
  • Phone: 316-962-3304
  • Fax: 316-962-2152
Mailing address:
  • Phone: 316-962-3304
  • Fax: 316-962-2152

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number75944
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number75944
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number2013009787
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: