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NPI Code Detail

MEDICARE: PAMELA ANN WILLIS-BROWN NP

MEDICARE:   PAMELA ANN WILLIS-BROWN  NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner53-75166-072KS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
153-75166-072OTHERKSKANSAS LICENSE

General Provider Information

NPI Number : 1306843909
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAMELA ANN WILLIS-BROWN NP
Provider Business Mailing Address
First Line : PO BOX 8035
Second Line :
City : WICHITA
State : KS
Zip : 67208-0035
Country : US
Telephone Number : 316-689-9135
Fax Number :
Provider Business Practice Location Address
First Line : 720 MEDICAL CENTER DR
Second Line :
City : NEWTON
State : KS
Zip : 67114-8778
Country : US
Telephone Number : 316-284-5155
Fax Number : 316-284-5050
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2005
Last Update Date : 07/27/2015

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Directions to “ PAMELA ANN WILLIS-BROWN NP” Practice Location

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