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NPI Code Detail

MEDICARE: GEORGE ROCCAFORTE ENP

MEDICARE: GEORGE ROCCAFORTE ENP
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
1363L00000XNurse Practitioner245101TX
2363LF0000XFamily Nurse Practitioner77366KS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1598780868
Entity Type Code : Individual
Provider Name (Legal Business Name) : GEORGE ROCCAFORTE ENP
Provider Business Mailing Address
First Line : 1122 N TOPEKA ST
Second Line :
City : WICHITA
State : KS
Zip : 67214-2810
Country : US
Telephone Number : 316-866-2000
Fax Number : 316-866-2084
Provider Business Practice Location Address
First Line : 1919 N AMIDON AVE STE 100
Second Line :
City : WICHITA
State : KS
Zip : 67203-2118
Country : US
Telephone Number : 316-866-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2006
Last Update Date : 02/07/2017

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Directions to “ GEORGE ROCCAFORTE ENP” Practice Location

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