Provider Demographics
NPI:1366702490
Name:AMUNEKE, RAYMOND (RN)
Entity type:Individual
Prefix:
First Name:RAYMOND
Middle Name:
Last Name:AMUNEKE
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1927 S LEEANNE LN
Mailing Address - Street 2:
Mailing Address - City:WHICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67207-7709
Mailing Address - Country:US
Mailing Address - Phone:316-393-1905
Mailing Address - Fax:316-686-3429
Practice Address - Street 1:1927 S LEEANNE LN
Practice Address - Street 2:
Practice Address - City:WHICHITA
Practice Address - State:KS
Practice Address - Zip Code:67207-7709
Practice Address - Country:US
Practice Address - Phone:316-393-1905
Practice Address - Fax:316-686-3429
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-23
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSA087-156251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health