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NPI Code Detail

MEDICARE: EMILY RUTH RUNYAN

MEDICARE: EMILY RUTH RUNYAN
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
1390200000XStudent in an Organized Health Care Education/Training Program13-92793-092KS
2363LF0000XFamily Nurse Practitioner46212KS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1285894709
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY RUTH RUNYAN
Provider Business Mailing Address
First Line : 8451 E PAWNEE ST
Second Line :
City : WICHITA
State : KS
Zip : 67207-5420
Country : US
Telephone Number : 316-618-0035
Fax Number : 316-633-4468
Provider Business Practice Location Address
First Line : 8451 E PAWNEE ST
Second Line :
City : WICHITA
State : KS
Zip : 67207-5420
Country : US
Telephone Number : 166-180-0353
Fax Number : 316-633-4468
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2008
Last Update Date : 09/10/2024

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