Provider Demographics
NPI:1114669785
Name:AZARA HOME HEALTH
Entity Type:Organization
Organization Name:AZARA HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HENNING
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:316-854-3619
Mailing Address - Street 1:3540 E 45TH ST N
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67220-1435
Mailing Address - Country:US
Mailing Address - Phone:408-529-6401
Mailing Address - Fax:
Practice Address - Street 1:2501 N ROOSEVELT ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67220-2814
Practice Address - Country:US
Practice Address - Phone:408-529-6401
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-12
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Single Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty