Healthcare Provider Details

I. General information

NPI: 1972286870
Provider Name (Legal Business Name): BRAD SAENS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2023
Last Update Date: 08/08/2023
Certification Date: 08/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 N PARKRIDGE ST
WICHITA KS
67212-4793
US

IV. Provider business mailing address

330 N PARKRIDGE ST
WICHITA KS
67212-4793
US

V. Phone/Fax

Practice location:
  • Phone: 620-491-0229
  • Fax:
Mailing address:
  • Phone: 620-491-0229
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License Number13-75354-091
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: