Individual
MIA S MANFREDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
415 N POPLAR AVE, WICHITA, KS 67214-4529
(316) 686-6671
(316) 686-1094
Mailing address
1365 N CUSTER ST, WICHITA, KS 67203-6634
(316) 686-6671
(316) 686-1094
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
53-75238-052
KS
364SP0810X
Child & Family Psychiatric/Mental Health Clinical Nurse Specialist
Primary
53-75238-052
KS
Other
Enumeration date
09/10/2010
Last updated
08/25/2017
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