Individual
KOMI N AGBODZIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
929 N SAINT FRANCIS ST, WICHITA, KS 67214-3821
(316) 268-5000
(316) 291-4272
Mailing address
PO BOX 2897, WICHITA, KS 67201-2897
(800) 374-5326
(800) 374-7656
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
13109541081
KS
163W00000X
Registered Nurse
2009029315
MO
367500000X
Certified Registered Nurse Anesthetist
Primary
557215
KS
Other
Enumeration date
11/22/2013
Last updated
03/03/2014
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