Healthcare Provider Details

I. General information

NPI: 1457682296
Provider Name (Legal Business Name): SHEILA KAY KOCHER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2010
Last Update Date: 02/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2707 E 21ST ST N
WICHITA KS
67214-2249
US

IV. Provider business mailing address

2707 E 21ST ST N PO BOX 239
WICHITA KS
67214-2249
US

V. Phone/Fax

Practice location:
  • Phone: 316-691-0249
  • Fax: 316-691-9875
Mailing address:
  • Phone: 316-691-0249
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LC1500X
TaxonomyCommunity Health Nurse Practitioner
License Number5374964041
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: