Individual
ELIZABETH HAYES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
10100 E SHANNON WOODS ST, SUITE 100, WICHITA, KS 67226-4104
(316) 219-8299
(316) 219-5899
Mailing address
2778 N WEBB RD, WICHITA, KS 67226-8112
(316) 631-1625
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
T-04370
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110848017
BLUE CROSS BLUE SHIELD
—
Enumeration date
09/28/2015
Last updated
09/25/2019
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