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General NPI Number Information
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NPI Number | 1134585615
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Entity Type | Organization
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Legal Business Name | J & K BARIATRIC NURSING, LLC
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Dates
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Enumeration Date | 01/13/2016
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Last Update Date | 05/19/2016
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Provider Practice Location Address
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Address Line | 1145 N ANDOVER RD SUITE 109
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City | ANDOVER
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State | KS
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Zip | 67002-8900
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Country | US
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Telephone | 316-733-8505
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Fax | 316-733-8279
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Provider Business Mailing Address
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Address Line | 1145 N ANDOVER RD SUITE 109
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City | ANDOVER
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State | KS
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Zip | 67002-8900
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Country | US
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Telephone | 316-733-8505
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Fax | 316-733-8279
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Authorized Official
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Title or Position | NURSE PRACTITIONER/MANAGER
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Name | KIMBERLY S FARRAR
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Credential | APRN
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Telephone | 316-733-8505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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