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General NPI Number Information
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NPI Number | 1659324663
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Entity Type | Individual
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Provider Name | DUANE C JAEGER ARNP, BC
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Gender | Male
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5500 E KELLOGG DR
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City | WICHITA
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State | KS
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Zip | 67218-1607
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Country | US
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Telephone | 316-651-3621
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Fax | 316-681-5570
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Provider Business Mailing Address
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Address Line | 828 SHADY WAY
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City | WICHITA
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State | KS
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Zip | 67203-3416
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Country | US
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Telephone | 316-651-3621
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Fax | 316-681-5570
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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 | 364SP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | 74618
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License Number State | KS
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