Individual
RAYMOND CHARLES TOMSHACK
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
(877) 649-7812
(918) 392-2941
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
13113634061
KS
367500000X
Certified Registered Nurse Anesthetist
149636
KS
367500000X
Certified Registered Nurse Anesthetist
Primary
557290
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201101760A
—
KS
Enumeration date
05/14/2014
Last updated
10/21/2014
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