Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 44208 | KS |
NPI | 1063508778 |
---|---|
Provider Name | Keri B Flowers |
First Address | Wichita, KS 67201 |
Second Address | Wichita, KS 67214 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
161224 | BCBS OF KANSAS (01) | KS |
460620 | FIRSTGUARD (01) | KS |