Individual
ANGELA MICHELLE THEOBALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1919 N AMIDON AVE STE 100, WICHITA, KS 67203-2118
(316) 866-2000
Mailing address
1122 N TOPEKA ST, WICHITA, KS 67214-2810
(316) 866-2000
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
53-77752
KS
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
77752
KS
Other
Enumeration date
07/12/2017
Last updated
02/13/2026
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