Organization
EMBOLD FOOT CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHANTELL DEBENHAM APRN (OWNER/PROVIDER)
(785) 576-9990
Entity
Organization
Contact information
Practice address
981 3600 AVE, ABILENE, KS 67410-6044
(785) 479-6401
Mailing address
981 3600 AVE, ABILENE, KS 67410-6044
(785) 576-9990
(785) 576-9990
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1215247416
—
KS
Enumeration date
01/16/2023
Last updated
02/02/2023
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