MEDICARE: MS. KARLA D HOSTETLER APRN

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	363L00000X	Nurse Practitioner	45657	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	45657	OTHER	KS	KS LICENSE

General Provider Information

NPI Number	:	1669436366
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KARLA D HOSTETLER APRN

Provider Business Mailing Address
First Line	:	PO BOX 8035
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67208-0035
Country	:	US
Telephone Number	:	316-689-9135
Fax Number	:	316-689-9102

Provider Business Practice Location Address
First Line	:	720 MEDICAL CENTER DR
Second Line	:
City	:	NEWTON
State	:	KS
Zip	:	67114-8778
Country	:	US
Telephone Number	:	316-284-5155
Fax Number	:	316-284-5110

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

Provider Enumeration Date	:	04/12/2006
Last Update Date	:	02/10/2025

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