Individual
NISHA BRUNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1010 N KANSAS ST, WICHITA, KS 67214-3199
(316) 293-2635
Mailing address
1010 N KANSAS ST, WICHITA, KS 67214-3199
(316) 293-2635
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
94-11724
KS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/19/2021
Last updated
06/06/2024
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