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NPI Code Detail

MEDICARE: MRS. KATHRYN NICOLE BUSBY-JORDAN BSW, MSW

MEDICARE:  MRS. KATHRYN NICOLE BUSBY-JORDAN  BSW, MSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker13664-TKS

General Provider Information

NPI Number : 1073355814
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KATHRYN NICOLE BUSBY-JORDAN BSW, MSW
Provider Business Mailing Address
First Line : 104 S 4TH ST STE 203
Second Line :
City : MANHATTAN
State : KS
Zip : 66502-6957
Country : US
Telephone Number : 785-473-8970
Fax Number :
Provider Business Practice Location Address
First Line : 104 S 4TH ST STE 203
Second Line :
City : MANHATTAN
State : KS
Zip : 66502-6957
Country : US
Telephone Number : 785-370-9355
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2024
Last Update Date : 06/12/2024

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Directions to “ MRS. KATHRYN NICOLE BUSBY-JORDAN BSW, MSW” Practice Location

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