Individual
MRS. STEPHANIE R NICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, ARNP, FNP
Contact information
Practice address
2020 N TYLER RD, STE 112, WICHITA, KS 67212-4905
(316) 312-0002
(316) 854-5644
Mailing address
2020 N TYLER RD, STE 112, WICHITA, KS 67212-4905
(316) 312-0002
(316) 854-5644
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
46074
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1497929483
NPI
KS
Enumeration date
04/21/2008
Last updated
10/27/2014
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