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General NPI Number Information
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NPI Number | 1518297803
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Entity Type | Organization
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Legal Business Name | DODGE CITY WOMENS HEALTH CLINIC INC
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Dates
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Enumeration Date | 01/08/2010
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Last Update Date | 06/20/2018
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Provider Practice Location Address
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Address Line | 2010 CENTRAL AVE
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City | DODGE CITY
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State | KS
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Zip | 67801-6442
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Country | US
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Telephone | 620-371-7270
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Fax | 620-371-7273
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Provider Business Mailing Address
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Address Line | PO BOX 1364
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City | DODGE CITY
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State | KS
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Zip | 67801-1364
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Country | US
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Telephone | 620-371-7270
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Fax | 620-371-7273
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Authorized Official
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Title or Position | ARNP/ ADMINISTRATOR
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Name | JACQUELYN SHARRIE KEMMERER
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Credential | ARNP
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Telephone | 913-449-9224
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 1354340071
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License Number State | KS
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