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Individual

CONNIE R WHITE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
7030 S BROADWAY ST, HAYSVILLE, KS 67060-1471
(316) 469-1099
(316) 469-1098
Mailing address
7030 S BROADWAY ST, HAYSVILLE, KS 67060-1471
(316) 469-1099
(316) 469-1098

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1600384
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200360660A
KS
Enumeration date
02/17/2006
Last updated
06/04/2009
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