Organization
COUNTY OF RILEY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BRENDA NICKEL MS RN (ADMINISTRATOR)
(785) 776-4779
Entity
Organization
Contact information
Practice address
2030 TECUMSEH RD, MANHATTAN, KS 66502-3512
(785) 776-4779
(785) 565-6566
Mailing address
2030 TECUMSEH RD, MANHATTAN, KS 66502-3541
(785) 776-4779
(785) 565-6565
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100097780A
—
KS
Enumeration date
06/27/2005
Last updated
02/26/2014
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