Provider Demographics
NPI:1790786978
Name:AYERS, DENISE MARIE
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:MARIE
Last Name:AYERS
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 1:7420 SWITZER
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66203-4550
Mailing Address - Country:US
Mailing Address - Phone:913-268-8033
Mailing Address - Fax:913-647-1223
Practice Address - Street 1:7420 SWITZER
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66203-4550
Practice Address - Country:US
Practice Address - Phone:913-268-8033
Practice Address - Fax:913-647-1223
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS13-55897-072163WM0705X
KS45199363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS29959016OtherBLUE SHIELD
KS29959016OtherBLUE SHIELD