Organization
DEPARTMENT OF VETERANS AFFAIRS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA SERVIORA (CREDENTIAL COORDINATOR)
(913) 682-2000
Entity
Organization
Contact information
Practice address
4101 S 4TH ST, LEAVENWORTH, KS 66048-5014
(913) 682-2000
Mailing address
4101 S 4TH ST, LEAVENWORTH, KS 66048-5014
(913) 682-2000
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
23-20087-011
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23-20087-011
NURSING LICENSE
KS
Enumeration date
02/08/2008
Last updated
02/08/2008
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