MEDICARE: VALARIE L KERSCHEN M.D.

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
1	208000000X	Pediatrics Physician	04-23762	KS
2	2080P0006X	Developmental - Behavioral Pediatrics Physician	04-23762	KS
3	2080P0008X	Pediatric Neurodevelopmental Disabilities Physician	04-23762	KS

General Provider Information

NPI Number	:	1922072073
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VALARIE L KERSCHEN M.D.

Provider Business Mailing Address
First Line	:	3243 E MURDOCK ST
Second Line	:	SUITE #500
City	:	WICHITA
State	:	KS
Zip	:	67208-3052
Country	:	US
Telephone Number	:	316-962-2080
Fax Number	:	316-962-2079

Provider Business Practice Location Address
First Line	:	3243 E MURDOCK ST
Second Line	:	SUITE #500
City	:	WICHITA
State	:	KS
Zip	:	67208-3052
Country	:	US
Telephone Number	:	316-962-2080
Fax Number	:	316-962-2079

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2006
Last Update Date	:	01/20/2022

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