Provider Demographics
NPI:1437141850
Name:STANTON COUNTY HOSPITAL
Entity Type:Organization
Organization Name:STANTON COUNTY HOSPITAL
Other - Org Name:JOHNSON CITY MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ARNP
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:LENAY
Authorized Official - Last Name:WYER
Authorized Official - Suffix:
Authorized Official - Credentials:RN/ARNP
Authorized Official - Phone:620-492-1595
Mailing Address - Street 1:PO BOX 502
Mailing Address - Street 2:
Mailing Address - City:JOHNSON
Mailing Address - State:KS
Mailing Address - Zip Code:67855-0502
Mailing Address - Country:US
Mailing Address - Phone:620-492-1595
Mailing Address - Fax:620-492-2384
Practice Address - Street 1:106 E. GREENWOOD NORTH
Practice Address - Street 2:
Practice Address - City:JOHNSON
Practice Address - State:KS
Practice Address - Zip Code:67855-0502
Practice Address - Country:US
Practice Address - Phone:620-492-1595
Practice Address - Fax:620-492-2384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-22
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS45751363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty