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General NPI Number Information
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NPI Number | 1326384264
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Entity Type | Individual
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Provider Name | MICHELLE MARIE WARDEN A.C.N.P.
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Gender | Female
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Dates
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Enumeration Date | 12/21/2012
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Last Update Date | 10/12/2019
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Provider Practice Location Address
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Address Line | 929 N SAINT FRANCIS AVE
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City | WICHITA
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State | KS
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Zip | 67214-3821
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Country | US
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Telephone | 316-268-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 10814 E LONGLAKE ST
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City | WICHITA
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State | KS
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Zip | 67207-5590
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Country | US
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Telephone | 316-613-2039
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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 | 714109
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 14-129654-122
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License Number State | KS
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Taxonomy #3
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 122795
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 53-76611-122
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License Number State | KS
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