Individual
CHARLES TYLER DICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
929 N SAINT FRANCIS ST, WICHITA, KS 67214-3821
(316) 268-5000
(316) 291-4272
Mailing address
PO BOX 2897, WICHITA, KS 67201-2897
(800) 374-5326
(800) 374-7656
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
13111340012
KS
367500000X
Certified Registered Nurse Anesthetist
149634
KS
367500000X
Certified Registered Nurse Anesthetist
Primary
557291
KS
Other
Enumeration date
05/21/2014
Last updated
10/21/2014
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