Healthcare Provider Details

I. General information

NPI: 1497683924
Provider Name (Legal Business Name): ANEW JOURNEY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7450 QUIVIRA RD
SHAWNEE KS
66216-3526
US

IV. Provider business mailing address

4601 E DOUGLAS AVE STE 150
WICHITA KS
67218-1011
US

V. Phone/Fax

Practice location:
  • Phone: 913-412-2589
  • Fax:
Mailing address:
  • Phone: 913-412-2589
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH FRYER
Title or Position: CEO
Credential: FNP-C, PMHNP-BC
Phone: 206-387-8028