# INTERVENTIONAL PAIN GROUP PA

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

## Provider details

- **NPI number:** 1558989277
- **Authorized official:** VIKKI LEIGH GAMBRILL CRNA (PRESIDENT)
- **Authorized official phone:** (913) 717-0177

## Contact information

- **Practice address:** 1004 PROGRESS DR STE 170, LANSING, KS 66043-6323
- **Practice address phone:** (913) 828-0136
- **Practice address fax:** (913) 828-0296
- **Mailing address:** PO BOX 269, LANSING, KS 66043-0269
- **Mailing address phone:** (913) 828-0136
- **Mailing address fax:** (913) 828-0296

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WP0000X | Pain Management Registered Nurse | — | — | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | — |
| 208VP0014X | Interventional Pain Medicine Physician | — | — | — |
| 261QP3300X | Pain Clinic/Center | — | — | — |
| 261QR0200X | Radiology Clinic/Center | — | — | — |

## Other

- **Enumeration date:** 07/09/2020
- **Last updated:** 08/02/2022