Individual
KATHY A DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-BC
Contact information
Practice address
711 GENN DR, WAMEGO, KS 66547-1179
(785) 456-2295
(785) 456-9467
Mailing address
711 GENN DR, WAMEGO, KS 66547-1179
(785) 456-2295
(785) 456-9467
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
44166
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100280380E
—
KS
01
—
13-36365-071
REGISTERED NURSE
KS
01
—
363LF0000X
TAXONOMY
KS
01
—
44166
LICENSE #
KS
Enumeration date
08/31/2005
Last updated
03/07/2023
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