Healthcare Provider Details

I. General information

NPI: 1730320367
Provider Name (Legal Business Name): KATHY ORNELAS CSA/CST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2009
Last Update Date: 03/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

818 N EMPORIA ST SUITE 200
WICHITA KS
67214-3729
US

IV. Provider business mailing address

818 N EMPORIA ST SUITE 200
WICHITA KS
67214-3729
US

V. Phone/Fax

Practice location:
  • Phone: 316-263-0296
  • Fax: 316-263-2315
Mailing address:
  • Phone: 316-263-0296
  • Fax: 316-263-2315

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZS0410X
TaxonomySurgical Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: