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NPI Code Detail

MEDICARE: REGINA AGWU ARNP

MEDICARE: REGINA AGWU ARNP
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
1363LC1500XCommunity Health Nurse Practitioner45073KS

General Provider Information

NPI Number : 1750594271
Entity Type Code : Individual
Provider Name (Legal Business Name) : REGINA AGWU ARNP
Provider Business Mailing Address
First Line : 6703 E WINTERBERRY CIR
Second Line :
City : WICHITA
State : KS
Zip : 67226-1252
Country : US
Telephone Number : 316-688-0947
Fax Number :
Provider Business Practice Location Address
First Line : 2716 W CENTRAL AVE
Second Line :
City : WICHITA
State : KS
Zip : 67203-4904
Country : US
Telephone Number : 316-660-7325
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2007
Last Update Date : 07/08/2007

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