Individual
ANDREA NISLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
550 N HILLSIDE ST, WICHITA, KS 67214-4910
(316) 962-2000
Mailing address
PO BOX 16928, WICHITA, KS 67216-0928
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
1502507
KS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/13/2021
Last updated
10/21/2021
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