Provider Demographics
NPI:1033118823
Name:CONANT, DENISE R (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:R
Last Name:CONANT
Suffix:
Gender:F
Credentials:ARNP
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Mailing Address - Street 1:203 WATSON ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PRATT
Mailing Address - State:KS
Mailing Address - Zip Code:67124-3068
Mailing Address - Country:US
Mailing Address - Phone:620-672-1002
Mailing Address - Fax:620-672-7268
Practice Address - Street 1:2300 N 14TH AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:DODGE CITY
Practice Address - State:KS
Practice Address - Zip Code:67801-2368
Practice Address - Country:US
Practice Address - Phone:620-225-7744
Practice Address - Fax:620-225-7002
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-14
Last Update Date:2010-08-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS45070363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100422670AMedicaid
KSP63508Medicare UPIN
KS100422670AMedicaid