Healthcare Provider Details

I. General information

NPI: 1811672843
Provider Name (Legal Business Name): CHRISTIAN CEDENO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2023
Last Update Date: 08/08/2025
Certification Date: 08/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1923 N WEBB RD
WICHITA KS
67206-3405
US

IV. Provider business mailing address

1923 N WEBB RD
WICHITA KS
67206-3405
US

V. Phone/Fax

Practice location:
  • Phone: 316-630-9300
  • Fax:
Mailing address:
  • Phone: 316-630-9300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number53-84553-081
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code163WX0800X
TaxonomyOrthopedic Registered Nurse
License Number13-152467-081
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: