Provider Demographics
NPI:1285192104
Name:WEHKAMP, MARINDA DAWN (NP-C)
Entity type:Individual
Prefix:
First Name:MARINDA
Middle Name:DAWN
Last Name:WEHKAMP
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:MARINDA
Other - Middle Name:DAWN
Other - Last Name:NEWKIRK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:311 E SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67846-5614
Mailing Address - Country:US
Mailing Address - Phone:620-271-3190
Mailing Address - Fax:806-358-3114
Practice Address - Street 1:311 E SPRUCE ST
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:KS
Practice Address - Zip Code:67846-5614
Practice Address - Country:US
Practice Address - Phone:620-271-3190
Practice Address - Fax:620-271-3117
Is Sole Proprietor?:No
Enumeration Date:2019-03-10
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS163856363L00000X, 363LG0600X
TXAPI140224363L00000X
TXAP140224363LG0600X
KS53-83402363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner