Individual
CARLY ANNE KNOBLAUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10111 E 21ST ST N STE 405, WICHITA, KS 67206-3581
(316) 796-5610
Mailing address
13701 W LOST CREEK ST, WICHITA, KS 67235-7043
(316) 619-9803
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
53-79808-022
KS
Other
Enumeration date
11/09/2020
Last updated
11/09/2020
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