Individual
KELLY M LYMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
9525 E 21ST ST N, WICHITA, KS 67206
(316) 631-1401
Mailing address
9525 E 21ST ST N, WICHITA, KS 67206-2946
(316) 631-1401
(316) 440-4470
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
44631
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
111178
MEDICARE GROUP NUMBER
—
01
—
48-1040759
GROUP TAX ID
KS
Enumeration date
08/16/2006
Last updated
06/12/2018
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