MEDICARE: RILEY BURGHART CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	160354	KS

General Provider Information

NPI Number	:	1063344414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RILEY BURGHART CRNA

Provider Business Mailing Address
First Line	:	6446 E. CENTRAL
Second Line	:	PO BOX 323
City	:	WICHITA
State	:	KS
Zip	:	67206
Country	:	US
Telephone Number	:	316-789-8444
Fax Number	:	316-789-8444

Provider Business Practice Location Address
First Line	:	6446 E. CENTRAL
Second Line	:	PO BOX 323
City	:	WICHITA
State	:	KS
Zip	:	67206
Country	:	US
Telephone Number	:	316-789-8444
Fax Number	:	316-789-8444

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

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Directions to “ RILEY BURGHART CRNA” Practice Location

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