Provider Demographics
NPI:1689861999
Name:WITCHEY, SHIRLEY L (RN, ARNP)
Entity Type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:L
Last Name:WITCHEY
Suffix:
Gender:F
Credentials:RN, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4401 W 109TH ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1303
Mailing Address - Country:US
Mailing Address - Phone:913-312-5100
Mailing Address - Fax:
Practice Address - Street 1:2226 E CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-4406
Practice Address - Country:US
Practice Address - Phone:316-263-7575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-01
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1333471041363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS0110035OtherBCBS OF KS