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General NPI Number Information
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NPI Number | 1659075273
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Entity Type | Organization
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Legal Business Name | ADVANCED CLINICAL CONSULTANTS LLC
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Dates
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Enumeration Date | 03/28/2023
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Last Update Date | 03/28/2023
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Provider Practice Location Address
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Address Line | 5901 W DRIFTWOOD ST
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City | WICHITA
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State | KS
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Zip | 67205-5265
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Country | US
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Telephone | 316-619-0411
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Fax |
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Provider Business Mailing Address
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Address Line | 5901 W DRIFTWOOD ST
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City | WICHITA
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State | KS
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Zip | 67205-5265
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Country | US
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Telephone | 316-619-0411
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Fax |
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Authorized Official
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Title or Position | APRN
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Name | DR. LAUREN SHELBY EWERTZ
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Credential | DNP, APRN, FNP-C
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Telephone | 316-619-0411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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