Provider Demographics
NPI:1770558538
Name:WERTH, IRENE (APRN)
Entity type:Individual
Prefix:
First Name:IRENE
Middle Name:
Last Name:WERTH
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:IRENE
Other - Middle Name:
Other - Last Name:CUNNINGHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:400 S SANTA FE AVE
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-4144
Mailing Address - Country:US
Mailing Address - Phone:785-452-7706
Mailing Address - Fax:785-452-7279
Practice Address - Street 1:5097 W CLOUD ST
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-9743
Practice Address - Country:US
Practice Address - Phone:800-423-1342
Practice Address - Fax:785-628-3113
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS45477363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100643090FMedicaid
KS161196Medicare ID - Type Unspecified