Provider Demographics
NPI:1396464889
Name:KEARNY COUNTY HEALTH DEPARTMENT
Entity type:Organization
Organization Name:KEARNY COUNTY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER ENROLLMENT
Authorized Official - Prefix:
Authorized Official - First Name:SHANON
Authorized Official - Middle Name:
Authorized Official - Last Name:ASHLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-500-1303
Mailing Address - Street 1:402 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LAKIN
Mailing Address - State:KS
Mailing Address - Zip Code:67860-6812
Mailing Address - Country:US
Mailing Address - Phone:620-355-6342
Mailing Address - Fax:620-355-7129
Practice Address - Street 1:402 N MAIN ST
Practice Address - Street 2:
Practice Address - City:LAKIN
Practice Address - State:KS
Practice Address - Zip Code:67860-6812
Practice Address - Country:US
Practice Address - Phone:620-355-6342
Practice Address - Fax:620-355-7129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-26
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare