Provider Demographics
NPI:1336485713
Name:WENNER, KAREN ANN (NP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:ANN
Last Name:WENNER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9119 W 74TH ST
Mailing Address - Street 2:SUITE 354
Mailing Address - City:MERRIAM
Mailing Address - State:KS
Mailing Address - Zip Code:66204-2215
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9119 W 74TH ST
Practice Address - Street 2:SUITE 354
Practice Address - City:MERRIAM
Practice Address - State:KS
Practice Address - Zip Code:66204-2215
Practice Address - Country:US
Practice Address - Phone:913-894-2121
Practice Address - Fax:913-894-9592
Is Sole Proprietor?:No
Enumeration Date:2012-12-12
Last Update Date:2012-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-75806-022363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner