| Doctor Name: | MICHELE WITHROW |
| NPI Number: | 1083046957 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN, PMHNP |
| License Number: | 53-76214-121 |
| Business Practice Address: | 6610 Se Quakervale Rd Riverton, KS - 667704185 |
| Business Phone Number: | 6208482300 |
| Business Fax Number: | |
| Mailing Address: | Po Box 550, RIVERTON |
| State: | KS |
| Postal Code: | 667700550 |
| Phone Number: | 6208482300 |
| Fax Number: | |
| NPI Enumeration Date: | 08/02/2013 |
| NPI Last Update Date: | 02/25/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | 53-76214-121 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KS |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |