Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | 53-78274-092 | KS |
NPI | 1013403039 |
---|---|
Provider Name | Allison Nicole Harned |
First Address | Wichita, KS 67205-8860 |
Second Address | Wichita, KS 67205 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2018 |
Last Update Date | 06/08/2018 |