Provider Demographics
NPI:1558948695
Name:HOPE MEDICAL FORENSIC SERVICES, LLC
Entity Type:Organization
Organization Name:HOPE MEDICAL FORENSIC SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:PECK
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:316-708-4099
Mailing Address - Street 1:2250 N ROCK RD # 118-266
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-2331
Mailing Address - Country:US
Mailing Address - Phone:316-708-4099
Mailing Address - Fax:949-209-5494
Practice Address - Street 1:430 S COMMERCE ST STE 300
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67202-4600
Practice Address - Country:US
Practice Address - Phone:316-708-4099
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-25
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty