Healthcare Provider Details

I. General information

NPI: 1720153125
Provider Name (Legal Business Name): JOANNE ARAIZA CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3311 E MURDOCK ST
WICHITA KS
67208-3054
US

IV. Provider business mailing address

3311 E MURDOCK ST
WICHITA KS
67208-3054
US

V. Phone/Fax

Practice location:
  • Phone: 316-689-9989
  • Fax: 316-689-9972
Mailing address:
  • Phone: 316-689-9989
  • Fax: 316-689-9972

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: