# CHENNELL FAMILY WELLNESS, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538647755
- **Authorized official:** ALICIA CHENNELL MD (OWNER)
- **Authorized official phone:** (620) 480-9597

## Contact information

- **Practice address:** 1101 N MAIN ST, MCPHERSON, KS 67460-2845
- **Practice address phone:** (620) 504-5996
- **Practice address fax:** (888) 263-5552
- **Mailing address:** 1101 N MAIN ST, MCPHERSON, KS 67460-2845
- **Mailing address phone:** (620) 504-5996
- **Mailing address fax:** (888) 263-5552

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 04-36397 | KS | Yes |

## Other

- **Enumeration date:** 07/31/2018
- **Last updated:** 10/14/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 04-36397 | STATE LICENSE | KS |
| 05 | — | 201207900A | — | KS |