Healthcare Provider Details

I. General information

NPI: 1902896327
Provider Name (Legal Business Name): KIMBERLY N SOMMER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2005
Last Update Date: 11/08/2024
Certification Date: 11/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 N HILLSIDE ST
WICHITA KS
67214-4976
US

IV. Provider business mailing address

3330 N GREY MEADOW CT
WICHITA KS
67205-8716
US

V. Phone/Fax

Practice location:
  • Phone: 316-962-2000
  • Fax:
Mailing address:
  • Phone: 316-204-9842
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number45695
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number45695
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: