Thach, Jodene R.

Thach, Jodene R. is an individual health care provider with primary practice located at 7200 W 13Th St N Suite 5, Wichita KS 67212-2970. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Adult Health is her primary health care specialty. Thach, Jodene R. can be contacted via phone (316) 239-7357.

Contact Information

Primary practice address
7200 W 13Th St N Suite 5 Wichita KS 67212-2970
Phone: (316) 239-7357
Fax: (316) 295-2356
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X CNP00557 New Mexico
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 36827 Kansas

Profile Details

NPI number 1801877295
LBN Legal business name Thach, Jodene R.
Credentials Certified Nurse Practitioner (CNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 11th, 2005
Last updated Sep 23rd, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801877295 NPPES
New Mexico MEDICAID L6477
New Mexico MEDICAID 201091430A

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