Healthcare Provider Details

I. General information

NPI: 1730715178
Provider Name (Legal Business Name): ANNA ALEXANDRA TITUS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2020
Last Update Date: 09/10/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 W MARY ST
GARDEN CITY KS
67846
US

IV. Provider business mailing address

510 W MARY ST
GARDEN CITY KS
67846-0766
US

V. Phone/Fax

Practice location:
  • Phone: 620-272-3600
  • Fax: 620-272-3606
Mailing address:
  • Phone: 620-272-3600
  • Fax: 620-272-3606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number53-80315-092
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: