Individual
VAN VAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1855 N WEBB RD, WICHITA, KS 67206-3413
(316) 636-2888
Mailing address
1855 N WEBB RD, WICHITA, KS 67206-3413
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
06/10/2022
Last updated
11/07/2022
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