Individual
NGOC-LIEN NGUYEN-GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1947 N FOUNDERS CIR, WICHITA, KS 67206-3548
(316) 613-4760
Mailing address
PO BOX 8035, WICHITA, KS 67208-0035
(316) 689-9135
(316) 689-9667
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1500684
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100372050C
—
KS
Enumeration date
11/02/2005
Last updated
05/21/2020
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