Individual
TANYA BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
9350 E CENTRAL AVE, WICHITA, KS 67206-2555
(316) 686-6608
(316) 686-3426
Mailing address
524 N ANDOVER RD, ANDOVER, KS 67002-9712
(316) 733-0716
(316) 733-1240
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1500710
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
426930
BCBS
KS
Enumeration date
03/30/2007
Last updated
03/02/2017
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