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General NPI Number Information
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NPI Number | 1174657225
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Entity Type | Organization
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Legal Business Name | ANDERSON FAMILY HEALTH, INC.
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2808 E CENTRAL AVE
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City | WICHITA
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State | KS
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Zip | 67214-4707
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Country | US
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Telephone | 316-440-4060
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Fax | 316-440-4058
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Provider Business Mailing Address
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Address Line | 2808 E. CENTRAL
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City | WICHITA
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State | KS
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Zip | 67214
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Country | US
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Telephone | 316-440-4060
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Fax | 316-440-4058
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Authorized Official
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Title or Position | OWNER
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Name | JEANNINE ANDERSON
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Credential |
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Telephone | 316-440-4060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 74510
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License Number State | KS
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