Individual
MARY C NILLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
9300 E 29TH ST N, STE 102, WICHITA, KS 67226-2182
(316) 687-2112
(316) 687-1260
Mailing address
21811 W 52ND ST N, ANDALE, KS 67001-9707
(316) 796-1155
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
45918
KS
Other
Enumeration date
04/02/2007
Last updated
07/08/2007
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