FORM 1023-EZ for WESTERN KANSAS NURSE PRACTITIONER ALLIANCE

Field Data
EIN 82-1094504
Case Number EO-2017117-000413
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name WESTERN KANSAS NURSE PRACTITIONER ALLIANCE
Organization’s Mailing Address X2459
City HAYS
State KS
ZIP 67601
Accounting period End 12
Primary contact name DENISE GARRISON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DIANA PFANNENSTIEL
PRESIDENT
2513 TIMBER DR
HAYS KS 67601

Officer/Director/Trustee Two

TONI YOUNGER
VICE-PRESIDENT
301 MONROE AVE
ELLIS KS 67601

Officer/Director/Trustee Three

KELLY MILLER
SECRETARY
1413 WEST 45TH
HAYS KS 67601

Officer/Director/Trustee Four

DENISE GARRISON
TREASURER
303 WEST 15TH
HAYS KS 67601

Officer/Director/Trustee Five

MICHELE KNOWLES
DIRECTOR
1551 220TH AVE
HAYS KS 67601

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/21/2017
Organization Incorporation State KS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E03 - Professional Societies, Associations
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee No
Donation of funds Yes
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance No
One Third Support Public No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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