Healthcare Provider Details

I. General information

NPI: 1699622555
Provider Name (Legal Business Name): JOSEPH NJUKU MAINA FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/11/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3343 W CENTRAL AVE
WICHITA KS
67203-4917
US

IV. Provider business mailing address

3343 W CENTRAL AVE
WICHITA KS
67203-4917
US

V. Phone/Fax

Practice location:
  • Phone: 316-260-4110
  • Fax: 316-351-5731
Mailing address:
  • Phone: 316-260-4110
  • Fax: 316-351-5731

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number82190
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: