Individual
EVA L HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
10111 E 21ST ST N STE 105, WICHITA, KS 67206-3555
(316) 260-5001
(316) 260-5424
Mailing address
10111 E 21ST ST N STE 105, WICHITA, KS 67206-3555
(316) 260-5001
(316) 260-5424
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0431204
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200337150A
—
KS
Enumeration date
07/27/2006
Last updated
12/19/2013
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