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General NPI Number Information
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NPI Number | 1891506010
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Entity Type | Individual
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Provider Name | JACKLINE EMELDAH ONONO CNA
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Gender | Female
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Dates
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Enumeration Date | 01/16/2025
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 1301 KS-264
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City | LARNED
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State | KS
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Zip | 67550
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Country | US
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Telephone | 620-285-2131
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Fax |
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Provider Business Mailing Address
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Address Line | 2754 S CYPRESS ST # 2754
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City | WICHITA
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State | KS
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Zip | 67210-2475
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Country | US
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Telephone | 316-550-7374
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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 | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | 256706
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License Number State | KS
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