Individual
KIMBERLY MCDORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
8080 E CENTRAL AVE, SUITE 250, WICHITA, KS 67206-2368
(316) 686-7327
(316) 858-1556
Mailing address
8080 E CENTRAL AVE, SUITE 250, WICHITA, KS 67206-2368
(316) 686-7327
(316) 858-1556
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
55020
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100405810C
—
KS
01
—
145029
BCBS
KS
01
—
P00153681
RAILROAD MEDICARE
KS
Enumeration date
01/21/2006
Last updated
03/24/2009
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