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General NPI Number Information
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NPI Number | 1770289555
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Entity Type | Individual
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Provider Name | KATHRYN CONNER RAPHAEL AGACNP BC
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Gender | Female
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Dates
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Enumeration Date | 02/03/2023
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Last Update Date | 02/03/2023
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Provider Practice Location Address
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Address Line | 5058 N REMINGTON ST
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City | BEL AIRE
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State | KS
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Zip | 67226-7605
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Country | US
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Telephone | 267-303-8891
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Fax |
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Provider Business Mailing Address
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Address Line | 5058 N REMINGTON ST
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City | BEL AIRE
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State | KS
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Zip | 67226-7605
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Country | US
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Telephone | 580-695-0130
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 81907
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License Number State | KS
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