Provider Demographics
NPI:1992941678
Name:THE WOUND NURSE, LLC
Entity type:Organization
Organization Name:THE WOUND NURSE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:LANDIS
Authorized Official - Suffix:
Authorized Official - Credentials:RN, WOCN
Authorized Official - Phone:316-708-2460
Mailing Address - Street 1:1515 S CLIFTON AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67218-2951
Mailing Address - Country:US
Mailing Address - Phone:316-351-7790
Mailing Address - Fax:316-425-8780
Practice Address - Street 1:1515 S CLIFTON AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67218-2951
Practice Address - Country:US
Practice Address - Phone:316-351-7790
Practice Address - Fax:316-425-8780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-30
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS6354660001Medicare NSC