Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | 53-76704-081 | KS |
NPI | 1518359439 |
---|---|
Provider Name | Tai Schmotzer |
First Address | Wichita, KS 67214-4436 |
Second Address | Wichita, KS 67214-4436 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2015 |
Last Update Date | 23/03/2021 |