Healthcare Provider Details

I. General information

NPI: 1710539879
Provider Name (Legal Business Name): SARAH M SHRINER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2019
Last Update Date: 05/05/2022
Certification Date: 05/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3121 N WEBB RD STE 101
WICHITA KS
67226-8119
US

IV. Provider business mailing address

1637 N WOODLAND AVE
WICHITA KS
67203-2739
US

V. Phone/Fax

Practice location:
  • Phone: 316-261-3130
  • Fax: 316-261-3275
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number15-02300
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: