Healthcare Provider Details

I. General information

NPI: 1447972674
Provider Name (Legal Business Name): CAROLINE N NJAU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2022
Last Update Date: 09/14/2022
Certification Date: 09/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 N WEBB RD
WICHITA KS
67226-8123
US

IV. Provider business mailing address

925 W 29TH ST S APT 212
WICHITA KS
67217-3140
US

V. Phone/Fax

Practice location:
  • Phone: 316-462-5000
  • Fax:
Mailing address:
  • Phone: 919-594-8195
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number145047
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: