Provider Demographics
NPI:1497923080
Name:FORGY, DENISE LEE
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:LEE
Last Name:FORGY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:821 SE 36TH ST. TERRACE
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66605
Mailing Address - Country:US
Mailing Address - Phone:785-851-0294
Mailing Address - Fax:
Practice Address - Street 1:120 SW FRAZIER AVE
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66606-2812
Practice Address - Country:US
Practice Address - Phone:785-232-2091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-15
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS13-84869-101163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)