Individual
DESIREE RUNQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
217 W IRA CT, ANDOVER, KS 67002
(316) 733-5047
Mailing address
7042 E KELLOGG DR, D, WICHITA, KS 67207-1638
(316) 295-7344
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
34880
KS
Other
Enumeration date
07/08/2014
Last updated
06/20/2018
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