Individual
ELEANOR G MILLSAP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1315 N WEST ST, WICHITA, KS 67203-1382
(316) 943-1295
Mailing address
6120 SHADYBROOK ST, WICHITA, KS 67208-1862
(316) 269-5000
(316) 269-0404
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
44970
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
161720
BLUECROSS BLUESHIELD KS
KS
05
—
200381990A
—
KS
01
—
P00353059
RAIL ROAD MEDICARE
—
Enumeration date
06/30/2006
Last updated
04/15/2013
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