Boon, Phanthavong

Boon, Phanthavong is an sole proprietor health care provider with primary practice located at 650 Huebner Rd , Fort Riley KS 66442-4030. He recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered. Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered is his primary health care specialty. Boon, Phanthavong can be contacted via phone (785) 239-7000.

Contact Information

Primary practice address
650 Huebner Rd Fort Riley KS 66442-4030
Phone: (785) 239-7000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 202201644RN Oregon
Nursing Service Providers / Registered Nurse 163W00000X 14-153121-072 Kansas
Nursing Service Providers / Registered Nurse 163W00000X 0001186892 Virginia
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 43-557812-072 Kansas
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 24179395 Virginia

Profile Details

NPI number 1184607285
LBN Legal business name Boon, Phanthavong
Credentials RN, CRNA
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 22nd, 2005
Last updated Feb 16th, 2022 - about 2 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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