| Psych-aprn, Llc | |
|
402 N Racehorse St Wichita KS 67235-8516 | |
| (316) 554-6711 | |
| Not Available |
| Full Name | Psych-aprn, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 402 N Racehorse St, Wichita, Kansas |
| Authorized Official Name and Position | Jacy Barker (OWNER) |
| Authorized Official Contact | 3165546711 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psych-aprn, Llc 402 N Racehorse St Wichita KS 67235-8516 Ph: () - | Psych-aprn, Llc 402 N Racehorse St Wichita KS 67235-8516 Ph: (316) 554-6711 |
| NPI Number | 1083378228 |
|---|---|
| Provider Enumeration Date | 10/25/2021 |
| Last Update Date | 07/06/2023 |
| Certification Date | 07/06/2023 |
| Medicare PECOS PAC ID | 1850781287 |
|---|---|
| Medicare Enrollment ID | O20211129001949 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083378228 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Jacy F Barker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407281272 PECOS PAC ID: 1557591997 Enrollment ID: I20140304000176 |
| Provider Name | Ashley R Melugin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881094902 PECOS PAC ID: 5597987677 Enrollment ID: I20141104002422 |
| Provider Name | Constance Jeanette Jacob |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639729726 PECOS PAC ID: 2668806589 Enrollment ID: I20200102000462 |
| Provider Name | Krystal L Mitchell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356956890 PECOS PAC ID: 6305265570 Enrollment ID: I20201007003305 |
| Provider Name | Sasha Lounmala |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003584244 PECOS PAC ID: 4981075249 Enrollment ID: I20230124001615 |
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