Provider Demographics
NPI:1366870164
Name:NANTSIS, KERRY MAY (APRN)
Entity type:Individual
Prefix:MRS
First Name:KERRY
Middle Name:MAY
Last Name:NANTSIS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MISS
Other - First Name:KERRY
Other - Middle Name:MAY
Other - Last Name:QUAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:PO BOX 47490
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67201-7490
Mailing Address - Country:US
Mailing Address - Phone:316-962-3100
Mailing Address - Fax:316-962-3132
Practice Address - Street 1:620 N CARRIAGE PKWY
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67208-4501
Practice Address - Country:US
Practice Address - Phone:316-962-3100
Practice Address - Fax:316-962-3132
Is Sole Proprietor?:No
Enumeration Date:2013-10-15
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-76161-102363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily