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Individual

MR. MICHAEL KENT EVANS

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1215 N RUTLAND ST, WICHITA, KS 67206-3837
(316) 636-2519
(316) 636-1014
Mailing address
1215 N RUTLAND ST, WICHITA, KS 67206-3837
(316) 636-2519
(316) 636-1014

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
13-35996-122
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
144571
BLUE SHIELD
KS
Enumeration date
03/16/2006
Last updated
07/08/2007
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