Organization
EAGLES NEST HOLISTIC MENTAL HEALTH INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LOIS ELLEN WILKINS APRN (OWNER/PRESIDENT)
(913) 530-2802
Entity
Organization
Contact information
Practice address
719 1/2 MASS. SUITE 100, LAWRENCE, KS 66044
(913) 530-2802
(913) 530-2802
Mailing address
32800 W 91ST TERRACE, DESOTO, KS 66018
(913) 530-2802
(913) 585-1157
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
14-58010-092
KS
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
14-58010-092RN
KS
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
74085APNR
KS
Other
Enumeration date
09/05/2008
Last updated
04/03/2018
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