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General NPI Number Information
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NPI Number | 1699719203
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Entity Type | Individual
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Provider Name | ALICIA A. HUCKSTADT PHD, ARNP, FNP
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Gender | Female
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Dates
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Enumeration Date | 06/15/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1845 FAIRMOUNT ST, BOX 41
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City | WICHITA
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State | KS
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Zip | 67260-0001
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Country | US
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Telephone | 316-978-5742
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Fax | 316-978-3094
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Provider Business Mailing Address
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Address Line | 13303 E. CAMDEN CHASE ST.
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City | WICHITA
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State | KS
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Zip | 67228-8028
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Country | US
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Telephone | 316-636-9248
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5344403
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 5344403
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License Number State | KS
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