Provider Demographics
NPI:1437617313
Name:GARVER, KIRSTEN D (APRN)
Entity Type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:D
Last Name:GARVER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:818 N CARRIAGE PKWY
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67208-4500
Mailing Address - Country:US
Mailing Address - Phone:316-651-2252
Mailing Address - Fax:316-651-2256
Practice Address - Street 1:818 N CARRIAGE PKWY
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67208-4500
Practice Address - Country:US
Practice Address - Phone:316-651-2252
Practice Address - Fax:316-651-2256
Is Sole Proprietor?:No
Enumeration Date:2019-03-09
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-78551363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS201233250AMedicaid