Provider Demographics
NPI:1801577275
Name:POUNDS, MARA (BSN, RN)
Entity type:Individual
Prefix:
First Name:MARA
Middle Name:
Last Name:POUNDS
Suffix:
Gender:
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1947 N SPRINGBROOK ST
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:KS
Mailing Address - Zip Code:67002-8654
Mailing Address - Country:US
Mailing Address - Phone:785-392-0818
Mailing Address - Fax:
Practice Address - Street 1:3701 E 13TH ST N BLDG 100
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67208-2004
Practice Address - Country:US
Practice Address - Phone:316-866-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-28
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS144443163WP2201X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program