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Individual

ANGELA FAY PARKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A.

Contact information

Practice address
550 N HILLSIDE ST, WICHITA, KS 67214-4910
(316) 962-9207
Mailing address
1015 N LEWELLEN ST, WICHITA, KS 67203-3568
(316) 393-9104

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1501255
KS
363A00000X
Physician Assistant
4169
SC
363A00000X
Physician Assistant
T-02258
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100224851
WI
05
4970PA
SC
Enumeration date
12/01/2008
Last updated
08/08/2023
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