Individual
MISS KATHY MAE WILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
106 WILLOW RD, GOODLAND, KS 67735-1518
(785) 890-6075
(785) 890-6077
Mailing address
106 WILLOW RD, GOODLAND, KS 67735-1518
(785) 890-6075
(785) 890-6077
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
44945
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100640620B
—
KS
01
—
1952685471
BCBS
KS
Enumeration date
10/03/2011
Last updated
08/08/2013
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