Healthcare Provider Details

I. General information

NPI: 1245403443
Provider Name (Legal Business Name): PAULA SUE FOSTER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PAULA SUE EMMONS APRN

II. Dates (important events)

Enumeration Date: 04/08/2008
Last Update Date: 07/29/2024
Certification Date: 07/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9350 E 35TH ST N STE 101
WICHITA KS
67226-2022
US

IV. Provider business mailing address

9350 E 35TH ST N STE 101
WICHITA KS
67226-2022
US

V. Phone/Fax

Practice location:
  • Phone: 316-265-1308
  • Fax: 316-265-4480
Mailing address:
  • Phone: 316-265-1308
  • Fax: 316-265-4480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number78087
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number13-68540-072
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: