Individual
MARY LU EGIDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2619 W. 6TH ST. SUITE C, LAWRENCE, KS 66049
(785) 830-8299
(785) 749-2581
Mailing address
2619 W 6TH ST. SUITE C, LAWRENCE, KS 66049
(785) 830-8299
(785) 749-2581
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
14-57857-101
KS
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
74564
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100297790 C
—
KS
01
—
160356
BCBS OF KS
KS
01
—
29894028
BCBS OF KC
KS
Enumeration date
09/05/2006
Last updated
01/23/2017
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