Organization
MINJA PSYCHIATRIC SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY MINJA APRN (OWNER)
(316) 371-7350
Entity
Organization
Contact information
Practice address
6611 E CENTRAL AVE STE C, WICHITA, KS 67206-1937
(316) 648-1157
(866) 316-4467
Mailing address
12002 W JEWELL CT, WICHITA, KS 67235-4100
(316) 371-7350
(866) 316-4467
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1013635903
NPI
KS
Enumeration date
08/17/2022
Last updated
03/03/2023
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