Individual
AMANDA TWIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
9300 E 29TH ST N, SUITE 320, WICHITA, KS 67226-2182
(316) 858-7100
(316) 858-7103
Mailing address
4900 S. MONACO ST, #210, DENVER, CO 80237-3486
(316) 858-7100
(316) 858-7103
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1500803
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100454610B
—
KS
05
—
100454610C
—
KS
Enumeration date
05/19/2006
Last updated
03/19/2012
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