MEDICARE: MRS. KIRSTEN HOANG PA-C, MPAS

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	363A00000X	Physician Assistant	15-00915	KS

General Provider Information

NPI Number	:	1962450726
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KIRSTEN HOANG PA-C, MPAS

Provider Business Mailing Address
First Line	:	3121 N WEBB RD STE 101
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67226-8119
Country	:	US
Telephone Number	:	316-261-3130
Fax Number	:	316-261-3275

Provider Business Practice Location Address
First Line	:	3121 N WEBB RD STE 101
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67226-8119
Country	:	US
Telephone Number	:	316-261-3130
Fax Number	:	316-261-3275

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

Provider Enumeration Date	:	05/04/2006
Last Update Date	:	05/13/2021

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