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Contact Information

KRISTY PROVENCE, APRN, BSN, WCC
15845 GARDNER WEST RD
GARDNER, KS66030-9507
 Phone: 913-207-5089
 Fax: 913-273-1094
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
 

Wound Care

163WW0000X
Indicates primary specialty

NPI Profile & details for KRISTY PROVENCE · (Female)

NPI Number 1346018686
Status Active
Credentials APRN, BSN, WCC
Entity Individual
Enumeration date 12/15/2023
Last updated 04/10/2025 - More than a year ago
Sole proprietor 1 Yes
Identifiers
  • KS License # 116337
  • KS License # 53-82741-021
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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