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General NPI Number Information
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NPI Number | 1598283707
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Entity Type | Individual
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Provider Name | JANICE MAI NGOC HOANG PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/07/2017
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Last Update Date | 09/18/2017
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Provider Practice Location Address
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Address Line | 2051 E MARY ST
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City | GARDEN CITY
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State | KS
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Zip | 67846-3617
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Country | US
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Telephone | 620-765-1450
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Fax |
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Provider Business Mailing Address
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Address Line | 4813 E PEMBROOK CT
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City | WICHITA
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State | KS
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Zip | 67220-2645
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Country | US
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Telephone |
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 15-02038
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License Number State | KS
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