Gina Marie Pack
Individual provider Active NPI Registered Nurse · Jetmore, KS
NPI 1942155239 · NPPES record last updated Mar 2, 2026
Key facts
- NPI
- 1942155239
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 13-149855-092 (KS)
- Practice address
- 309 Main St
Jetmore, KS 67854-9200 - Phone
- (620) 357-8736
- Fax
- (620) 357-8846
- NPI assigned
- Mar 2, 2026
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13-149855-092 | KS | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Hodgeman | Current | Accepting new patients | |
| County of Hodgeman | Current | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 13-149855-092 | KS | Yes |
Addresses
Primary practice location
309 Main St
Jetmore, KS 67854-9200
Mailing address
3303 Cervantes Rd
Dodge City, KS 67801-7263
Phone (620) 357-8736
Other providers in Jetmore, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 2, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.