Provider Demographics
NPI:1154050003
Name:LEHRMAN, MAKENNA JO
Entity Type:Individual
Prefix:
First Name:MAKENNA
Middle Name:JO
Last Name:LEHRMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 E 32ND ST
Mailing Address - Street 2:
Mailing Address - City:HAYS
Mailing Address - State:KS
Mailing Address - Zip Code:67601-1698
Mailing Address - Country:US
Mailing Address - Phone:785-301-2250
Mailing Address - Fax:785-301-2270
Practice Address - Street 1:217 E 32ND ST
Practice Address - Street 2:
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601-1698
Practice Address - Country:US
Practice Address - Phone:785-301-2250
Practice Address - Fax:785-301-2270
Is Sole Proprietor?:No
Enumeration Date:2022-06-07
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
KS15-02693363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant