Ediger, Jacque Elaine

Ediger, Jacque Elaine is an individual health care provider with primary practice located at 5500 E Kellogg Dr Bldg 5- Robert J Dole Va Medical Center, Wichita KS 67218-1607. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Adult, which is considered as her primary health care specialty. Ediger, Jacque Elaine can be contacted via phone (316) 634-3058.

Contact Information

Primary practice address
5500 E Kellogg Dr Bldg 5- Robert J Dole Va Medical Center Wichita KS 67218-1607
Phone: (316) 634-3058
Fax: (316) 634-3091
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Adult 364SP0809X 74824 Kansas

Profile Details

NPI number 1285683599
LBN Legal business name Ediger, Jacque Elaine
Credentials ARNP,BC
Entity Individual
Sole proprietor 1 No
Enumeration date May 6th, 2006
Last updated Jul 9th, 2007 - about 18 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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Identifiers

StateTypeNumberIssuer
All States NPI 1285683599 NPPES
Kansas MEDICAID 5615865701

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