Provider Demographics
NPI:1336572940
Name:STRECKER, KELCIE L (PA-C)
Entity Type:Individual
Prefix:
First Name:KELCIE
Middle Name:L
Last Name:STRECKER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KELCIE
Other - Middle Name:L
Other - Last Name:HUBACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2200 SW 6TH AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66606-1707
Mailing Address - Country:US
Mailing Address - Phone:785-354-8518
Mailing Address - Fax:785-354-1255
Practice Address - Street 1:3511 CLINTON PL STE C
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66047-2213
Practice Address - Country:US
Practice Address - Phone:785-331-4488
Practice Address - Fax:785-331-4338
Is Sole Proprietor?:No
Enumeration Date:2013-08-19
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS15-01628363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant