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Individual

MS. MARY MAGATHAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
8918 W 21ST ST N, SUITE 200, #265, WICHITA, KS 67205-1885
(316) 721-2705
Mailing address
8918 W 21ST ST N, SUITE 200, #265, WICHITA, KS 67205-1885
(316) 721-2705

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
44046
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
044923
BCBS
KS
Enumeration date
05/21/2008
Last updated
05/21/2008
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