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General NPI Number Information
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NPI Number | 1265592232
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Entity Type | Organization
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Legal Business Name | MONTOYA FAMILY PRACTICE, PA
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 02/03/2023
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Provider Practice Location Address
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Address Line | 8451 E PAWNEE ST
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City | WICHITA
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State | KS
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Zip | 67207-5420
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Country | US
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Telephone | 316-618-0035
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Fax | 316-618-0010
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Provider Business Mailing Address
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Address Line | 8451 E PAWNEE ST
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City | WICHITA
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State | KS
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Zip | 67207-5420
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Country | US
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Telephone | 316-618-0035
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Fax | 316-618-0010
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Authorized Official
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Title or Position | OWNER
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Name | DR. NATALIA MONTOYA
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Credential | M.D.
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Telephone | 316-618-0035
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 15-00731
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 45218
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License Number State | KS
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0429228
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License Number State | KS
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