Provider Demographics
NPI:1821287517
Name:WEHLING-JUHL, KELLI A (ARNP)
Entity Type:Individual
Prefix:
First Name:KELLI
Middle Name:A
Last Name:WEHLING-JUHL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:KELLI
Other - Middle Name:A
Other - Last Name:WILLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:4900 S. MONACO ST
Mailing Address - Street 2:#210
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3486
Mailing Address - Country:US
Mailing Address - Phone:316-858-7100
Mailing Address - Fax:316-858-7103
Practice Address - Street 1:9300 E 29TH ST N
Practice Address - Street 2:STE 320
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226-2182
Practice Address - Country:US
Practice Address - Phone:316-858-7100
Practice Address - Fax:316-858-7103
Is Sole Proprietor?:No
Enumeration Date:2007-10-17
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS46119363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200528020CMedicaid
KS200528020CMedicaid
KSKA1908003Medicare PIN