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NPI Code Detail

MEDICARE: CAROLYN S KLIEWER PA-C

MEDICARE:   CAROLYN S KLIEWER  PA-C
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
1363A00000XPhysician Assistant15-00792KS

General Provider Information

NPI Number : 1457355901
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROLYN S KLIEWER PA-C
Provider Business Mailing Address
First Line : 1515 S CLIFTON AVE STE 300
Second Line :
City : WICHITA
State : KS
Zip : 67218-2953
Country : US
Telephone Number : 316-858-0550
Fax Number :
Provider Business Practice Location Address
First Line : 1515 S CLIFTON AVE STE 300
Second Line :
City : WICHITA
State : KS
Zip : 67218-2953
Country : US
Telephone Number : 316-858-0550
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2005
Last Update Date : 04/03/2025

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Directions to “ CAROLYN S KLIEWER PA-C” Practice Location

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