Organization
NORTHEAST KANSAS CENTER FOR HEALTH AND WELLNESS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DALE A WHITE (CFO)
(785) 486-2642
Entity
Organization
Contact information
Practice address
240 W 18TH ST, HORTON, KS 66439-1245
(785) 486-2642
(785) 486-2842
Mailing address
240 W 18TH ST, HORTON, KS 66439-1245
(785) 486-2642
(785) 486-2842
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
H-007-002
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004631
BC-BS OF KS
KS
Enumeration date
06/11/2007
Last updated
08/22/2020
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