Healthcare Provider Details

I. General information

NPI: 1902729791
Provider Name (Legal Business Name): BRIANA REA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6110 W KELLOGG DR STOP 1
WICHITA KS
67209-2350
US

IV. Provider business mailing address

9002 W CHARTWELL CIR
WICHITA KS
67205-1445
US

V. Phone/Fax

Practice location:
  • Phone: 316-945-8181
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number1-102228
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: