Individual
MRS. DIANE M MALCOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, BSN, CWS
Contact information
Practice address
5500 E KELLOGG DR, WICHITA, KS 67218-1607
(316) 685-2221
(316) 651-2954
Mailing address
5500 E KELLOGG DR, WICHITA, KS 67218-1607
(316) 685-2221
(316) 651-2954
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
Primary
13-40815-072
KS
Other
Enumeration date
03/30/2009
Last updated
03/30/2009
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