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General NPI Number Information
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NPI Number | 1033619085
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Entity Type | Individual
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Provider Name | GINA JANEA ABRAHAM APRN
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Gender | Female
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Dates
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Enumeration Date | 02/16/2018
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Last Update Date | 11/17/2020
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Provider Practice Location Address
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Address Line | 530 N RIDGE RD STE B
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City | WICHITA
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State | KS
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Zip | 67212-6576
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Country | US
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Telephone | 316-616-1055
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Fax | 855-633-0585
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Provider Business Mailing Address
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Address Line | 530 N RIDGE RD STE B
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City | WICHITA
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State | KS
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Zip | 67212-6576
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Country | US
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Telephone | 405-544-0265
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Fax | 855-223-1999
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 53-77978-091
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License Number State | KS
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