Healthcare Provider Details

I. General information

NPI: 1437151727
Provider Name (Legal Business Name): KIMBERLY L TALBOT ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2005
Last Update Date: 11/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2260 N RIDGE RD STE 240
WICHITA KS
67205-1138
US

IV. Provider business mailing address

2260 N RIDGE RD STE 240
WICHITA KS
67205-1138
US

V. Phone/Fax

Practice location:
  • Phone: 316-838-7700
  • Fax: 316-838-8770
Mailing address:
  • Phone: 316-838-7700
  • Fax: 316-838-8770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License Number74374
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: