Provider Demographics
NPI:1003560830
Name:WAITHERERO, ESTHER NDUTA (PMHNP)
Entity Type:Individual
Prefix:
First Name:ESTHER
Middle Name:NDUTA
Last Name:WAITHERERO
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2522 E EVANSTON CIR
Mailing Address - Street 2:
Mailing Address - City:PARK CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67219-2333
Mailing Address - Country:US
Mailing Address - Phone:316-992-6359
Mailing Address - Fax:
Practice Address - Street 1:1737 SE US HIGHWAY 54
Practice Address - Street 2:
Practice Address - City:EL DORADO
Practice Address - State:KS
Practice Address - Zip Code:67042-8264
Practice Address - Country:US
Practice Address - Phone:316-321-7284
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-10
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-80774-102363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health