Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2100X | Nurse Practitioner - Acute Care | 2016001659 | MO |
Y | 363LA2100X | Nurse Practitioner - Acute Care | 5377146111 | KS |
NPI | 1043678113 |
---|---|
Provider Name | Hailey Wank |
First Address | Lenexa, KS 66219-2301 |
Second Address | Lenexa, KS 66219-2301 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/02/2016 |
Last Update Date | 04/04/2017 |