Organization
WILSON COUNTY HOSPITAL
Active
Other names
Wilson Medical Center Professional
Organization subpart
No
Provider details
NPI number
Authorized official
LORI C SMITH (CFO)
(620) 325-8388
Entity
Organization
Contact information
Practice address
2600 OTTAWA RD, NEODESHA, KS 66757-1897
(620) 325-2611
(620) 325-8459
Mailing address
PO BOX 360, NEODESHA, KS 66757-0360
(620) 325-2611
(620) 325-8453
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
H103002
KS
367500000X
Certified Registered Nurse Anesthetist
H103002
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100099210D
—
KS
Enumeration date
01/31/2007
Last updated
09/25/2024
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