Individual
BEATRICE TANG DISASI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12526 E CENTRAL AVE, WICHITA, KS 67206-2812
(316) 616-5306
(316) 260-9229
Mailing address
PO BOX 780204, WICHITA, KS 67278-0204
(316) 616-5306
Taxonomy
Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary
264
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
82-2384276
—
KS
Enumeration date
09/05/2017
Last updated
06/16/2018
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