Divine, Amanda Gail

Divine, Amanda Gail is an individual health care provider with primary practice located at 8725 E 32Nd St N , Wichita KS 67226-4008. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Divine, Amanda Gail can be contacted via phone (316) 201-1202.

Contact Information

Primary practice address
8725 E 32Nd St N Wichita KS 67226-4008
Phone: (316) 201-1202
Fax: (316) 201-1251
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 53-78308-011 Kansas
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 2016013652 Missouri

Profile Details

NPI number 1336591049
LBN Legal business name Divine, Amanda Gail
Credentials NURSE
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 6th, 2016
Last updated Mar 11th, 2020 - about 6 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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