Provider Demographics
NPI:1821228099
Name:SCHULTE, KENNETH W (MED)
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:W
Last Name:SCHULTE
Suffix:
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1724 E 30TH AVE
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67502-1239
Mailing Address - Country:US
Mailing Address - Phone:620-669-8700
Mailing Address - Fax:
Practice Address - Street 1:4601 PEACH TREE LN
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67502-1648
Practice Address - Country:US
Practice Address - Phone:620-669-9150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-21
Last Update Date:2009-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS203106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist