Judith K Algrim, ARNP

Individual provider Active NPI Nurse Practitioner · Wichita, KS

NPI 1790737302 · NPPES record last updated Dec 17, 2013

Key facts

NPI
1790737302
Entity type
Individual (NPI type 1)
Primary specialty
Nurse Practitioner 363L00000X
License
44177 (KS)
Practice address
347 S Laura St
Wichita, KS 67211-1518
Phone
(316) 686-7117
Fax
(316) 686-2679
NPI assigned
May 16, 2006
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
44177KSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wichita Medical Associates, PA Past
since Dec 5, 1992
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 44177 KS Yes

Addresses

Primary practice location

347 S Laura St
Wichita, KS 67211-1518

Mailing address

347 S Laura St
Wichita, KS 67211-1518
Phone (316) 686-7117

Other identifiers

IdentifierTypeStateIssuer
100253410AMedicaidKS

Other providers in Wichita, KS

All providers in Wichita, KS · Nurse Practitioner in Kansas

Sources for this page

Verify at the official NPI Registry.