Provider Demographics
NPI:1700098415
Name:SUNRISE-SUNSET, LC
Entity Type:Organization
Organization Name:SUNRISE-SUNSET, LC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGATHAN
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, RNC, ARNP, CCM
Authorized Official - Phone:620-274-4280
Mailing Address - Street 1:8918 W 21ST ST N STE 200
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67205-1880
Mailing Address - Country:US
Mailing Address - Phone:316-721-2705
Mailing Address - Fax:316-721-0911
Practice Address - Street 1:8918 W 21ST ST N STE 200
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67205-1880
Practice Address - Country:US
Practice Address - Phone:316-721-2705
Practice Address - Fax:316-721-0911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1326921-032363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty