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General NPI Number Information
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NPI Number | 1841097755
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Entity Type | Individual
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Provider Name | TRACY LYNN KINDERKNECHT RN
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Gender | Female
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Dates
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Enumeration Date | 02/27/2025
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Last Update Date | 02/27/2025
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Provider Practice Location Address
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Address Line | 806 NISHNABE TRL
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City | ROSSVILLE
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State | KS
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Zip | 66533-9812
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Country | US
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Telephone | 785-584-6171
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Fax |
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Provider Business Mailing Address
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Address Line | 806 NISHNABE TRL
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City | ROSSVILLE
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State | KS
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Zip | 66533-9812
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Country | US
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Telephone | 785-584-6171
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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 | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number | 13-87117-081
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License Number State | KS
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