Individual
JANA NISLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
720 MEDICAL CENTER DR, NEWTON, KS 67114-8778
(316) 283-6103
Mailing address
720 MEDICAL CENTER DR, NEWTON, KS 67114-8778
(316) 283-6103
(316) 283-1333
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
04-021468
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30004742620001
—
KS
Enumeration date
08/28/2020
Last updated
04/28/2023
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