Healthcare Provider Details

I. General information

NPI: 1912445453
Provider Name (Legal Business Name): EMILY HEALY APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2017
Last Update Date: 02/04/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3232 E MURDOCK ST
WICHITA KS
67208-3003
US

IV. Provider business mailing address

3232 E MURDOCK ST
WICHITA KS
67208-3003
US

V. Phone/Fax

Practice location:
  • Phone: 316-685-7234
  • Fax: 316-685-0317
Mailing address:
  • Phone: 316-685-7234
  • Fax: 316-685-0317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberTMP-154178
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: