Organization
VIA CHRISTI IMMEDIATE CARE, MOTHER MARY ANNE INC.
Active
Other names
Via Christi Mother Mary Anne Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NANCY D BETTIS (CREDENTIALING SPECIALIST)
(316) 268-5266
Entity
Organization
Contact information
Practice address
1152 S. CLIFTON, WICHITA, KS 67218-2913
(316) 689-5121
(316) 689-5122
Mailing address
1152 S. CLIFTON, WICHITA, KS 67218-2913
(316) 689-5121
(316) 689-5122
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200452390A
—
KS
Enumeration date
02/06/2007
Last updated
07/22/2010
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