Individual
DEBRA JEAN KLECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
5500 E KELLOGG DR, WICHITA, KS 67218-1607
(316) 685-2221
Mailing address
5500 E KELLOGG DR, WICHITA, KS 67218-1607
(316) 685-2221
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
53-74946-122
KS
363LF0000X
Family Nurse Practitioner
627339
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110238008
PTAN
KS
05
—
184122303
—
TX
05
—
200619290A
—
KS
Enumeration date
01/01/2007
Last updated
04/24/2015
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