Individual
MRS. MALISSA KAY PAXTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPAC
Contact information
Practice address
606 MULBERRY RD, DERBY, KS 67037-3532
(316) 788-3787
(316) 788-6930
Mailing address
1305 PARKWOOD CT, DERBY, KS 67037-8897
(316) 789-0240
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
15-00798
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15-00798
KS ST BOARD LICENSE
KS
01
—
P00099501
RAILROAD MEDICARE
KS
Enumeration date
09/26/2006
Last updated
07/19/2013
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