Individual
GINA MARIE PACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
309 MAIN ST, JETMORE, KS 67854-9200
(620) 357-8736
(620) 357-8846
Mailing address
3303 CERVANTES RD, DODGE CITY, KS 67801-7263
(620) 357-8736
(620) 357-8846
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
13-149855-092
KS
Other
Enumeration date
03/02/2026
Last updated
03/02/2026
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