Provider Demographics
NPI:1164069290
Name:MCCAMMON, ASHLEE MORGAN
Entity Type:Individual
Prefix:
First Name:ASHLEE
Middle Name:MORGAN
Last Name:MCCAMMON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ASHLEE
Other - Middle Name:MORGAN
Other - Last Name:WINKELBAUER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8700 E 29TH ST N
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-2169
Mailing Address - Country:US
Mailing Address - Phone:316-634-8710
Mailing Address - Fax:316-634-8891
Practice Address - Street 1:8700 E 29TH ST N
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226-2169
Practice Address - Country:US
Practice Address - Phone:316-634-8710
Practice Address - Fax:316-634-8891
Is Sole Proprietor?:No
Enumeration Date:2019-12-09
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS201273820AMedicaid