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General NPI Number Information
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NPI Number | 1124852066
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Entity Type | Organization
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Legal Business Name | BLUE SKY PRIMARY CARE PA
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Dates
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Enumeration Date | 08/30/2024
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Last Update Date | 11/14/2025
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Provider Practice Location Address
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Address Line | 925 N HILLSIDE ST
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City | WICHITA
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State | KS
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Zip | 67214-3219
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Country | US
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Telephone | 316-689-4203
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Fax | 316-235-2460
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Provider Business Mailing Address
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Address Line | 925 N HILLSIDE ST
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City | WICHITA
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State | KS
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Zip | 67214-3219
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Country | US
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Telephone | 316-689-4203
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Fax | 316-235-2496
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | KARI EDWARDS
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Credential |
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Telephone | 316-616-3333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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