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Individual

LISA GORGES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
124 S 1ST ST, COLWICH, KS 67030-8816
(316) 712-9703
Mailing address
12014 ROLLING HILLS DR, WICHITA, KS 67235-1302
(316) 491-0189

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
F01191231
KS
363LF0000X
Family Nurse Practitioner
78571
KS

Other

Enumeration date
01/26/2019
Last updated
01/09/2023
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