Individual
MARYBETH VAN ROEKEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.R.N.P.
Contact information
Practice address
214 W MAIN ST, LOGAN, KS 67646-9764
(785) 689-4220
(785) 689-4219
Mailing address
1719 HIGHWAY 183, P.O. BOX 547, PHILLIPSBURG, KS 67661-2549
(785) 543-5211
(785) 543-5274
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
44437
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100281250B
—
KS
01
—
101941
BC/BS PROVIDER NUMBER
KS
Enumeration date
05/30/2006
Last updated
08/28/2015
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