Individual
MS. JESSICA MARIE BRACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
5500 E KELLOGG DR, WICHITA, KS 67218-1607
(316) 685-2221
Mailing address
3202 N GREY MEADOW ST, WICHITA, KS 67205-8715
(309) 444-7181
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
14140719
KS
Other
Enumeration date
10/07/2024
Last updated
10/07/2024
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