Doctor Name: | ERNEST FRANCIA DEGENHARDT |
NPI Number: | 1407837404 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | NURSE PRACTITIONER |
License Number: | |
Business Practice Address: | 550 Pope Ave Munson Army Health Center (attn) Mcxn-cod. Ms Cotton Fort Leavenworth, KS - 660272332 |
Business Phone Number: | 9136846562 |
Business Fax Number: | 9136846208 |
Mailing Address: | 550 Pope Ave, Munson Army Health Center (attn) Mcxn-cod. Ms Cotton FORT LEAVENWORTH |
State: | KS |
Postal Code: | 660272332 |
Phone Number: | 9136846562 |
Fax Number: | 9136846208 |
NPI Enumeration Date: | 11/08/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |