Individual
MARY ELIZABETH MEDFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ACNPC-AG
Contact information
Practice address
21905 W 51ST TER, SHAWNEE, KS 66226-3874
(701) 361-9431
Mailing address
21905 W 51ST TER, SHAWNEE, KS 66226-3874
(701) 361-9431
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
2021030039
MO
363LA2100X
Acute Care Nurse Practitioner
53-80387-122
KS
Other
Enumeration date
08/05/2021
Last updated
08/05/2021
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