Individual
KATELYN HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
527 N GROVE ST, WICHITA, KS 67214-4520
(316) 262-2415
Mailing address
739 S DELLROSE AVE, WICHITA, KS 67218-2311
(303) 550-3633
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15-02726
KS
363A00000X
Physician Assistant
PA.0007101
CO
363AM0700X
Medical Physician Assistant
PA.0007101
CO
Other
Enumeration date
11/19/2021
Last updated
12/14/2023
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