| Chennell Family Wellness, Llc | |
|
1101 N Main St Mcpherson KS 67460-2845 | |
| (620) 504-5996 | |
| (888) 263-5552 |
| Full Name | Chennell Family Wellness, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1101 N Main St, Mcpherson, Kansas |
| Authorized Official Name and Position | Alicia Chennell (OWNER) |
| Authorized Official Contact | 6204809597 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chennell Family Wellness, Llc 1101 N Main St Mcpherson KS 67460-2845 Ph: (620) 504-5996 | Chennell Family Wellness, Llc 1101 N Main St Mcpherson KS 67460-2845 Ph: (620) 504-5996 |
| NPI Number | 1538647755 |
|---|---|
| Provider Enumeration Date | 07/31/2018 |
| Last Update Date | 10/14/2020 |
| Medicare PECOS PAC ID | 6507118460 |
|---|---|
| Medicare Enrollment ID | O20181004001621 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538647755 | NPI | - | NPPES |
| 04-36397 | Other | KS | STATE LICENSE |
| 201207900A | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 04-36397 (Kansas) | Primary |
| Provider Name | Alicia R Chennell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639465982 PECOS PAC ID: 1557598646 Enrollment ID: I20140728002369 |
| Provider Name | Samantha M Claassen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184281644 PECOS PAC ID: 3971839622 Enrollment ID: I20221005003327 |
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