Individual
JESSICA LIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
5501 N 183RD ST W, COLWICH, KS 67030-9640
(316) 208-5118
Mailing address
5501 N 183RD ST W, COLWICH, KS 67030-9640
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
13-122147-102
KS
Other
Enumeration date
10/31/2022
Last updated
10/31/2022
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