Provider Demographics
NPI:1639494719
Name:WEST, DOROTHY (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:DOROTHY
Middle Name:
Last Name:WEST
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14546 46TH ST
Mailing Address - Street 2:
Mailing Address - City:PERRY
Mailing Address - State:KS
Mailing Address - Zip Code:66073-4078
Mailing Address - Country:US
Mailing Address - Phone:785-863-2824
Mailing Address - Fax:
Practice Address - Street 1:2921 SW WANAMAKER DR
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66614-5328
Practice Address - Country:US
Practice Address - Phone:785-272-6860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-01
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-75079-022363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS110426013Medicare PIN