=====================================================
General NPI Number Information
=====================================================
NPI Number | 1023935723
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DAN KEARNS RN
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/02/2026
-----------------------------------------------------
Last Update Date | 07/02/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10300 W MAPLE ST
-----------------------------------------------------
City | WICHITA
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 67209-3135
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 316-633-9148
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10300 W MAPLE ST
-----------------------------------------------------
City | WICHITA
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 67209-3135
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 316-633-9148
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WG0600X
-----------------------------------------------------
Taxonomy Name | Gerontology Registered Nurse
-----------------------------------------------------
License Number | 13-103242-102
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------