Individual
JACQUELINE A GORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9350 E 35TH ST N, SUITE 101, WICHITA, KS 67226-2019
(316) 265-1308
Mailing address
7627 E 37TH ST N, APT #2001, WICHITA, KS 67226-2802
(316) 641-5446
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15-01133
KS
Other
Enumeration date
05/03/2008
Last updated
05/03/2008
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