Healthcare Provider Details

I. General information

NPI: 1952500340
Provider Name (Legal Business Name): VALERIE A. ANDERSON RN, BSN, MSN, ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. VALERIE A DIRKS

II. Dates (important events)

Enumeration Date: 07/16/2007
Last Update Date: 04/04/2025
Certification Date: 04/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9211 E 21ST ST N
WICHITA KS
67206-2900
US

IV. Provider business mailing address

PO BOX 8035
WICHITA KS
67208
US

V. Phone/Fax

Practice location:
  • Phone: 316-274-4501
  • Fax: 316-636-4076
Mailing address:
  • Phone: 316-689-9135
  • Fax: 316-689-9667

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number53-46065
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number13-80994-082
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: