Healthcare Provider Details

I. General information

NPI: 1790308070
Provider Name (Legal Business Name): BRITTANY KAY TOMPKINS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2020
Last Update Date: 08/02/2021
Certification Date: 08/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

551 N HILLSIDE ST STE 201
WICHITA KS
67214-4923
US

IV. Provider business mailing address

551 N HILLSIDE ST STE 201
WICHITA KS
67214-4923
US

V. Phone/Fax

Practice location:
  • Phone: 316-263-0296
  • Fax: 316-263-9523
Mailing address:
  • Phone: 316-263-0296
  • Fax: 316-263-9523

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number15-02403
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: