Individual
CRYSTAL SUE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5101 S ASH ST, WICHITA, KS 67216-3224
(316) 641-1136
Mailing address
5500 E KELLOGG DR, WICHITA, KS 67218-1607
(316) 641-1136
(316) 469-0815
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
13-127206
KS
Other
Enumeration date
07/27/2023
Last updated
07/27/2023
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