Individual
LISA JAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1919 N AMIDON AVE STE 130, WICHITA, KS 67203-2118
(316) 660-7750
Mailing address
271 W 3RD ST N STE 600, WICHITA, KS 67202-1223
(316) 660-7600
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
108304
KS
Other
Enumeration date
08/09/2022
Last updated
08/09/2022
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