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Individual

KYLE B HANEY

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
Mailing address
PO BOX 2897, WICHITA, KS 67201-2897
(800) 374-5326
(800) 374-7656

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
100045
KS
367500000X
Certified Registered Nurse Anesthetist
147494
KS
367500000X
Certified Registered Nurse Anesthetist
Primary
557203
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201084880A
KS
Enumeration date
06/26/2013
Last updated
01/15/2014
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