Bruce Nystrom in Wichita - Clinical Child & Adolescent
Bruce Nystrom - NPI 1700983368
Bruce Nystrom is a Clinical Child & Adolescent in Wichita, Kansas. Bruce Nystrom practices all healthcare services and medical treatments related to Clinical Child & Adolescent. The NPI Number for Bruce Nystrom is 1700983368. The last update date is 2022-08-30.
Bruce Nystrom's current location address is 727 N Waco Ave Ste 320, Wichita, Kansas. You can contact this provider via phone number 3166160260 and fax number 3166160264. The mailing address for Bruce Nystrom is 727 N Waco Ave Ste 320, Wichita, Kansas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Bruce Nystrom |
|---|---|
| Address | 727 N Waco Ave Ste 320, Wichita, Kansas |
| Phone Number | 3166160260 |
| Fax Number | 3166160264 |
| Sole Proprietor | Y |
| Credentials | PHD |
NPI Number Detail
| NPI Number | 1700983368 |
|---|---|
| Provider Enumeration Date | 2006-09-17 |
| Last Updated Date | 2022-08-30 |
Provider Mailing Address Detail
| Address | 727 N Waco Ave Ste 320 |
|---|---|
| City | Wichita |
| State | Kansas (KS) |
| Post Code | 672033972 |
| Phone Number | 3166160260 |
| Fax Number | 3166160264 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical Child & Adolescent |
|---|---|
| Taxonomy | 103Tc2200X |
| Licence No | 610 |
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Definition: A psychologist who develops and applies scientific knowledge to the delivery of psychological services to infants, toddlers, children and adolescents within their social context. Of particular importance to the specialty of clinical child psychology |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 100239970 B | KS | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Bruce Nystrom by the Centers for Medicare & Medicaid Services?
The Bruce Nystrom has been issued the NPI (National Provider Identifier) 1700983368 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Can you provide the Bruce Nystrom's physical address?
The Bruce Nystrom is physically located at 727 N Waco Ave Ste 320, in the city of Wichita, KS, with the postal code 672033972.
What is Bruce Nystrom's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Bruce Nystrom is Clinical Child & Adolescent, and the taxonomy code that categorizes this field of expertise is 103Tc2200X.
When did Bruce Nystrom receive its 1700983368 assignment?
The Bruce Nystrom was assigned its 1700983368 on 2006-09-17, which is the date when this unique identifier was issued to the organization.
As of what date was the information regarding Bruce Nystrom, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Bruce Nystrom, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2022-08-30.