Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 25839 | OK |
Y | 2080P0207X | Pediatric Hematology-Oncologist | 271839 | NY |
NPI | 1083811962 |
---|---|
Provider Name | Dr. Elisa J Stauffer |
First Address | Wichita, KS 67208-3007 |
Second Address | Wichita, KS 67208-3007 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2007 |
Last Update Date | 24/11/2020 |