Individual
VICKI L DWYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
2600 N WOODLAWN ST, WICHITA, KS 67220-2729
(316) 684-3838
(316) 858-2521
Mailing address
2600 N WOODLAWN ST, WICHITA, KS 67220-2729
(316) 684-3838
(316) 858-2521
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
74790
KS
364SP0200X
Pediatric Clinical Nurse Specialist
74790
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100642350A
—
KS
05
—
100642350B
—
KS
Enumeration date
01/19/2006
Last updated
02/10/2011
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