Healthcare Provider Details

I. General information

NPI: 1689313876
Provider Name (Legal Business Name): ANGELA CHRISTINE AZZARITO MSN-FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2022
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3223 N WEBB RD STE 1
WICHITA KS
67226-8176
US

IV. Provider business mailing address

3223 N WEBB RD STE 1
WICHITA KS
67226-8176
US

V. Phone/Fax

Practice location:
  • Phone: 316-609-2600
  • Fax: 316-609-2800
Mailing address:
  • Phone: 316-609-2600
  • Fax: 316-609-2800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number53-81227-091
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: