Individual
STEPHANIE ROATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5500 E KELLOGG DR, WICHITA, KS 67218-1607
(316) 685-2221
Mailing address
11242 W 13TH CT N, WICHITA, KS 67212-5701
(316) 518-2671
Taxonomy
Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
Primary
1392448021
KS
Other
Enumeration date
02/10/2023
Last updated
02/10/2023
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