Individual
MRS. GINA JANEA ABRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
530 N RIDGE RD STE B, WICHITA, KS 67212-6576
(316) 616-1055
(855) 633-0585
Mailing address
530 N RIDGE RD STE B, WICHITA, KS 67212-6576
(405) 544-0265
(855) 223-1999
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
53-77978-091
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201197560A
—
KS
Enumeration date
02/16/2018
Last updated
11/17/2020
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