Individual
DR. MONA B. BRAKE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5500 E KELLOGG DR, WICHITA, KS 67218-1607
(316) 685-2221
Mailing address
5500 E KELLOGG DR, WICHITA, KS 67218-1607
(316) 685-2221
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
0426354
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0426354
STATE LICENCE NUMBER
KS
Enumeration date
05/02/2006
Last updated
07/08/2007
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