Healthcare Provider Details

I. General information

NPI: 1457852360
Provider Name (Legal Business Name): ALICIA MARIE MEFFORD APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2018
Last Update Date: 02/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 W ELM ST
WICHITA KS
67203-3848
US

IV. Provider business mailing address

141 W ELM ST
WICHITA KS
67203-3848
US

V. Phone/Fax

Practice location:
  • Phone: 316-660-0850
  • Fax: 316-660-0872
Mailing address:
  • Phone: 316-660-0850
  • Fax: 316-660-0872

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
License Number77945
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: