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General NPI Number Information
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NPI Number | 1275243487
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Entity Type | Individual
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Provider Name | NELLIE LYNN MCCUNE MSN, APRN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 11/29/2022
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Last Update Date | 03/30/2023
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Provider Practice Location Address
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Address Line | 21276 SW SHUMWAY RD
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City | DOUGLASS
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State | KS
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Zip | 67039-8257
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Country | US
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Telephone | 316-619-5343
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Fax |
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Provider Business Mailing Address
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Address Line | 21276 SW SHUMWAY RD
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City | DOUGLASS
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State | KS
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Zip | 67039-8257
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Country | US
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Telephone | 316-619-5343
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Fax |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 13-149076-041
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 53-81750-041
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License Number State | KS
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