Healthcare Provider Details

I. General information

NPI: 1194930990
Provider Name (Legal Business Name): SHILOH S. JIWANLAL ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 N TOPEKA ST
WICHITA KS
67202-2413
US

IV. Provider business mailing address

12128 E KILLENWOOD DR
WICHITA KS
67206-4124
US

V. Phone/Fax

Practice location:
  • Phone: 316-263-6941
  • Fax: 316-263-5259
Mailing address:
  • Phone: 316-682-2212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number74209
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number13-49131-062
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: