Basic Information
| Provider Information | |||||||||
| NPI: | 1629063375 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NONHOF | ||||||||
| FirstName: | KAREN | ||||||||
| MiddleName: | L. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7560 LINDSAY DR | ||||||||
| Address2: | |||||||||
| City: | HOLCOMB | ||||||||
| State: | KS | ||||||||
| PostalCode: | 678519783 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6202772087 | ||||||||
| FaxNumber: | 6202754729 | ||||||||
| Practice Location | |||||||||
| Address1: | 712 SAINT JOHN ST | ||||||||
| Address2: | |||||||||
| City: | GARDEN CITY | ||||||||
| State: | KS | ||||||||
| PostalCode: | 678465128 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6202751766 | ||||||||
| FaxNumber: | 6202754729 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/19/2005 | ||||||||
| LastUpdateDate: | 10/19/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 04-18913 | KS | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 2050186701 | 05 | KS | MEDICAID | 020453 | 01 | KS | BC/BS PROVIDER NUMBER | OTHER |