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General NPI Number Information
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NPI Number | 1225277338
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Entity Type | Individual
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Provider Name | GAYLE RENEE NOLLER RN
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Gender | Female
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Dates
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Enumeration Date | 02/12/2009
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Last Update Date | 02/12/2009
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Provider Practice Location Address
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Address Line | 1035 N EMPORIA ST SUITE 155
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City | WICHITA
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State | KS
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Zip | 67214-2944
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Country | US
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Telephone | 316-440-3900
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Fax | 316-440-3905
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Provider Business Mailing Address
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Address Line | 2558 VENTNOR DR
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City | PARK CITY
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State | KS
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Zip | 67219-1751
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Country | US
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Telephone | 316-305-6744
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Fax | 316-440-3905
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WA2000X
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Taxonomy Name | Administrator Registered Nurse
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License Number | 13-78671-052
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License Number State | KS
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