Provider Demographics
NPI:1053419861
Name:KROHN, KIMBERLY TURNER (MD)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:TURNER
Last Name:KROHN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:WESLEY FAMILY MEDICINE RESIDENCY
Mailing Address - Street 2:850 NORTH HILLSIDE
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67214
Mailing Address - Country:US
Mailing Address - Phone:316-967-3976
Mailing Address - Fax:316-962-9184
Practice Address - Street 1:WESLEY FAMILY MEDICINE RESIDENCY
Practice Address - Street 2:850 NORTH HILLSIDE
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214
Practice Address - Country:US
Practice Address - Phone:316-967-3976
Practice Address - Fax:316-962-9184
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND7753207Q00000X
KS04-42166207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND10372Medicaid
NDG51871Medicare UPIN
ND10372Medicaid