Individual
JANA E ULTZSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2770 N WEBB RD, WICHITA, KS 67226-8112
(800) 374-5326
(800) 374-7656
Mailing address
PO BOX 2897, WICHITA, KS 67201-2897
(800) 374-5326
(800) 374-7656
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
54443
KS
367500000X
Certified Registered Nurse Anesthetist
Primary
54443
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100254500A
—
KS
Enumeration date
08/16/2005
Last updated
07/06/2010
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