NPI 1962650705 · live from the CMS NPI Registry
Eagles Nest Holistic Mental Health INC
Nurse Practitioner, Psych/Mental Health in Lawrence, KS. National Provider Identifier 1962650705, active.
NPI record
| NPI | 1962650705 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Psych/Mental Health 363LP0808X |
| Practice location | 719 1/2 Mass. Suite 100, Lawrence, KS 66044 |
| Practice phone | 913-530-2802 |
| Mailing address | 32800 W 91st Terrace, Desoto, KS 66018 |
| Enumerated | September 5, 2008 |
| Last updated | April 3, 2018 |
| Authorized official | Lois Wilkins, Owner/President |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse, Psych/Mental Health, Adult | 163WP0809X | 14-58010-092 (KS) |
| Nurse Practitioner, Psych/Mental Health | 363LP0808X | 14-58010-092RN (KS) |
| Nurse Practitioner, Psych/Mental Health primary | 363LP0808X | 74085APNR (KS) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.