Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 76670 | KS |
NPI | 1134508088 |
---|---|
Provider Name | Victoria Capps |
First Address | Wichita, KS 67235-1223 |
Second Address | Wichita, KS 67214-4910 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2015 |
Last Update Date | 26/05/2015 |