Healthcare Provider Details

I. General information

NPI: 1548136997
Provider Name (Legal Business Name): PHOENIX RISING PSYCHIATRIC SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

423 N MCLEAN BLVD
WICHITA KS
67203-5964
US

IV. Provider business mailing address

423 N MCLEAN BLVD STE 213
WICHITA KS
67203-5964
US

V. Phone/Fax

Practice location:
  • Phone: 316-619-7080
  • Fax:
Mailing address:
  • Phone: 316-619-7080
  • Fax: 316-202-5197

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KRISTIN LEE HALL
Title or Position: OWNER
Credential: APRN, PMHNP
Phone: 316-619-7080