| Leavenworth Family Health Center | |
|
720 1st Ter Lansing KS 66043-1704 | |
| (913) 682-5588 | |
| (913) 682-2698 |
| Full Name | Leavenworth Family Health Center |
|---|---|
| Speciality | Family Medicine |
| Location | 720 1st Ter, Lansing, Kansas |
| Authorized Official Name and Position | Peter J Cristiano (OWNER) |
| Authorized Official Contact | 9136825588 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Leavenworth Family Health Center 720 1st Ter Lansing KS 66043-1704 Ph: (913) 682-5588 | Leavenworth Family Health Center 720 1st Ter Lansing KS 66043-1704 Ph: (913) 682-5588 |
| NPI Number | 1255446480 |
|---|---|
| Provider Enumeration Date | 08/20/2006 |
| Last Update Date | 06/16/2025 |
| Medicare PECOS PAC ID | 8628973740 |
|---|---|
| Medicare Enrollment ID | O20031203000159 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255446480 | NPI | - | NPPES |
| 100316200A | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Peter J Cristiano |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710092093 PECOS PAC ID: 6507761624 Enrollment ID: I20031208000351 |
| Provider Name | Mira Kim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710212477 PECOS PAC ID: 1850550567 Enrollment ID: I20120315000103 |
| Provider Name | Valerie Faye Watts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962893263 PECOS PAC ID: 9830405620 Enrollment ID: I20150824001795 |
| Provider Name | Anna Shuck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346885670 PECOS PAC ID: 3173952116 Enrollment ID: I20200326002503 |
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