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NPI Code Detail

MEDICARE: AMANDA J ZOGLEMAN APRN

MEDICARE: AMANDA J ZOGLEMAN APRN
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
1363LF0000XFamily Nurse Practitioner53-78989KS

General Provider Information

NPI Number : 1801435342
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA J ZOGLEMAN APRN
Provider Business Mailing Address
First Line : 2135 N COLLECTIVE LN
Second Line :
City : WICHITA
State : KS
Zip : 67206-3560
Country : US
Telephone Number : 316-261-3220
Fax Number : 316-261-3298
Provider Business Practice Location Address
First Line : 126 MAIN ST
Second Line :
City : HALSTEAD
State : KS
Zip : 67056-1708
Country : US
Telephone Number : 316-835-3700
Fax Number : 316-283-1333
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/01/2020
Last Update Date : 04/28/2023

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