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General NPI Number Information
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NPI Number | 1629620406
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Entity Type | Individual
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Provider Name | BRENDA KAY DINGES APRN FNP-C
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Gender | Female
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Dates
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Enumeration Date | 07/12/2019
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Last Update Date | 07/30/2019
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Provider Practice Location Address
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Address Line | 5815 BROADWAY AVE
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City | GREAT BEND
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State | KS
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Zip | 67530-3123
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Country | US
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Telephone | 620-792-2544
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Fax | 620-792-7052
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Provider Business Mailing Address
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Address Line | 9773 M RD
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City | NESS CITY
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State | KS
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Zip | 67560-6029
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Country | US
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Telephone | 785-798-5223
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 53-78872-062
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 78872
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License Number State | KS
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