Provider Demographics
NPI:1417687880
Name:COMPREHENSIVE CARE OF KANSAS, LLC
Entity Type:Organization
Organization Name:COMPREHENSIVE CARE OF KANSAS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER / ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAVERKAMP
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, FNP-C
Authorized Official - Phone:316-665-7165
Mailing Address - Street 1:111 S WHITTIER RD
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67207-1045
Mailing Address - Country:US
Mailing Address - Phone:316-665-7165
Mailing Address - Fax:
Practice Address - Street 1:111 S WHITTIER RD
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67207-1045
Practice Address - Country:US
Practice Address - Phone:316-665-7165
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-16
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care