Davis, Angela

Davis, Angela is an sole proprietor health care provider with primary practice located at 808 W Maple St , Wichita KS 67213-5508. She recently has only one registered license in Other Service Providers / Community Health Worker, which is considered as her primary health care specialty. Davis, Angela can be contacted via phone (316) 990-2574.

Contact Information

Primary practice address
808 W Maple St Wichita KS 67213-5508
Phone: (316) 990-2574
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Community Health Worker 172V00000X

Profile Details

NPI number 1124456314
LBN Legal business name Davis, Angela
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 24th, 2013
Last updated Oct 24th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124456314 NPPES
Kansas MEDICAID 200558500A

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