Healthcare Provider Details

I. General information

NPI: 1033044367
Provider Name (Legal Business Name): NICHOLAS CARL WIENS DNAP, CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 S SANTA FE AVE
SALINA KS
67401-4144
US

IV. Provider business mailing address

3207 N CHAMBERS ST
WICHITA KS
67205-7544
US

V. Phone/Fax

Practice location:
  • Phone: 785-452-7000
  • Fax:
Mailing address:
  • Phone: 316-300-6425
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number43-558412-012
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: