Healthcare Provider Details

I. General information

NPI: 1962531749
Provider Name (Legal Business Name): PATRICIA D CORNING RN, CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 S HILLSIDE ST
WICHITA KS
67211-2152
US

IV. Provider business mailing address

200 S HILLSIDE ST
WICHITA KS
67211-2152
US

V. Phone/Fax

Practice location:
  • Phone: 316-687-3100
  • Fax: 316-687-0286
Mailing address:
  • Phone: 316-687-3100
  • Fax: 316-687-0286

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number1359739021
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: