Healthcare Provider Details

I. General information

NPI: 1194639658
Provider Name (Legal Business Name): CHANTEL LYN MAGILL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1645 S HYDRAULIC ST
WICHITA KS
67211-4500
US

IV. Provider business mailing address

6420 E RODEO ST
BEL AIRE KS
67226-1414
US

V. Phone/Fax

Practice location:
  • Phone: 316-973-4475
  • Fax:
Mailing address:
  • Phone: 316-973-4475
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number108965
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: