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PROFESSIONAL PHYSICALS, LLC

Nursing Service Providers Registered Nurse

Provider NPI: 1548313471

Organization Information:
Organization Name:  PROFESSIONAL PHYSICALS, LLC
Authorized Official:  TANDY SUZANNE NOELLER  OWNER  620-736-2639

Practice Location:
2045 12TH STREET  SEVERY, KS 67137-0093 US
Tel: 620-736-2639  Fax: 620-736-2639

Business Mailing Address:
2045 12TH STREET PO BOX 93 SEVERY, KS 67137-0093 US
Tel: 620-736-2639  Fax: 620-736-2639

NPI Information:
NPI: 1548313471
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
X163W00000XNursing Service Providers
Registered Nurse
KS13-33753-081
X163WC1600XNursing Service Providers
Registered Nurse
KS13-33753-081
X163WC3500XNursing Service Providers
Registered Nurse
KS13-33753-081
X163WD0400XNursing Service Providers
Registered Nurse
KS13-33753-081
X163WW0000XNursing Service Providers
Registered Nurse
KS13-33753-081
X363L00000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
KS44916
X363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
KS44916
X363LX0106XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
KS44916
X364S00000XPhysician Assistants & Advanced Practice Nursing Providers
Clinical Nurse Specialist
KS74710
X364SF0001XPhysician Assistants & Advanced Practice Nursing Providers
Clinical Nurse Specialist
KS74710
X364SH1100XPhysician Assistants & Advanced Practice Nursing Providers
Clinical Nurse Specialist
KS74710
X364SM0705XPhysician Assistants & Advanced Practice Nursing Providers
Clinical Nurse Specialist
KS74710
X364SX0106XPhysician Assistants & Advanced Practice Nursing Providers
Clinical Nurse Specialist
KS74710

Other Provider Identifiers:

IssuerNumberStateType
BCBSKS0000161786KS01




MEDICAL JOBS KS - Page 1

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