Provider Demographics
NPI:1043710742
Name:ANCAR, KELLY LISA (RN)
Entity Type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:LISA
Last Name:ANCAR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 E 19TH ST
Mailing Address - Street 2:
Mailing Address - City:HAYS
Mailing Address - State:KS
Mailing Address - Zip Code:67601-3218
Mailing Address - Country:US
Mailing Address - Phone:785-432-2920
Mailing Address - Fax:888-298-5222
Practice Address - Street 1:2004 HALL ST
Practice Address - Street 2:
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601-3140
Practice Address - Country:US
Practice Address - Phone:785-259-6907
Practice Address - Fax:888-298-5222
Is Sole Proprietor?:No
Enumeration Date:2018-02-19
Last Update Date:2018-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS75076163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health