Organization
COLLEGE HILL OB/GYN, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIGNON LYNN BREWSTER RN (PRACTICE ADMINISTRATOR)
(316) 871-1148
Entity
Organization
Contact information
Practice address
3233 E 2ND ST N, WICHITA, KS 67208-3202
(316) 683-6766
(316) 616-0073
Mailing address
3233 E 2ND ST N, WICHITA, KS 67208-3202
(316) 683-6766
(316) 616-0073
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100392890A
—
KS
01
—
17D0927901
CLIA ID #
KS
Enumeration date
02/15/2006
Last updated
10/23/2024
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