Healthcare Provider Details

I. General information

NPI: 1447644018
Provider Name (Legal Business Name): HERMES HEALTHCARE PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2015
Last Update Date: 08/06/2020
Certification Date: 08/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3343 W CENTRAL AVE
WICHITA KS
67203-4917
US

IV. Provider business mailing address

3343 W CENTRAL AVE
WICHITA KS
67203-4917
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number45939
License Number StateKS

VIII. Authorized Official

Name: JAYNE HERMES
Title or Position: OWNER
Credential: APRN
Phone: 316-260-4110