Healthcare Provider Details

I. General information

NPI: 1528063328
Provider Name (Legal Business Name): PATRICE K RAWLINS ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2005
Last Update Date: 07/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3243 E MURDOCK ST SUITE #500
WICHITA KS
67208-3052
US

IV. Provider business mailing address

3243 E MURDOCK ST SUITE #500
WICHITA KS
67208-3052
US

V. Phone/Fax

Practice location:
  • Phone: 316-962-2080
  • Fax: 316-962-2079
Mailing address:
  • Phone: 316-962-2080
  • Fax: 316-962-2079

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number74050
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: