Individual
ANDREA STAFFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1491 N COOLIDGE AVE, WICHITA, KS 67203-2982
(316) 737-5425
Mailing address
1491 N COOLIDGE AVE, WICHITA, KS 67203-2982
(316) 737-5425
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
78296
KS
Other
Enumeration date
07/27/2018
Last updated
07/27/2018
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