Organization
NEUROSURGERY ASSIST, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGIA DENNE (MANAGER)
(316) 269-5000
Entity
Organization
Contact information
Practice address
929 N SAINT FRANCIS ST, WICHITA, KS 67214-3821
(316) 268-5050
Mailing address
6120 SHADYBROOK ST, WICHITA, KS 67208-1862
(316) 269-5000
(316) 269-0404
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
111120
BCBS
KS
05
—
200371470A
—
KS
Enumeration date
06/24/2006
Last updated
09/15/2009
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