Healthcare Provider Details

I. General information

NPI: 1336060672
Provider Name (Legal Business Name): NOHA ABDELRAHMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 N HILLSIDE ST
WICHITA KS
67214-4910
US

IV. Provider business mailing address

2023 N BROADMOOR ST UNIT 274
WICHITA KS
67206-2681
US

V. Phone/Fax

Practice location:
  • Phone: 316-962-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number9412755
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: