Angela Michelle Theobald, | |
1919 N Amidon Ave Ste 100, Wichita, KS 67203-2118 | |
(316) 866-2000 | |
Not Available |
Full Name | Angela Michelle Theobald |
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Gender | Female |
Speciality | Nurse Practitioner - Family |
Location | 1919 N Amidon Ave Ste 100, Wichita, Kansas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1427570373 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | 53-77752 (Kansas) | Primary |
Entity Name | Gracemed Health Clinic Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1184691693 PECOS PAC ID: 9830098185 Enrollment ID: O20040106000520 |
Entity Name | Soma Recovery Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1750850723 PECOS PAC ID: 7810387339 Enrollment ID: O20211123003204 |
Mailing Address | Practice Location Address |
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Angela Michelle Theobald, 1122 N Topeka St, Wichita, KS 67214-2810 Ph: (316) 866-2000 | Angela Michelle Theobald, 1919 N Amidon Ave Ste 100, Wichita, KS 67203-2118 Ph: (316) 866-2000 |
Mavis A Schultz, ARNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3100 N Hillside St, Wichita, KS 67219 Phone: 316-682-3100 Fax: 316-618-8537 | |
Jacob Loveless, NURSE PRACTITIONER Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 818 N Emporia St Ste 200, Wichita, KS 67214 Phone: 316-263-0296 | |
Amanda Barrett, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2707 E 21st St N, Wichita, KS 67214 Phone: 316-691-0249 | |
Mr. Norman Keith Trevolt, ARNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 848 N. St Francis, Ste 3901, Wichita, KS 67214 Phone: 316-268-8500 Fax: 316-291-7993 | |
Kathryn M Filby, ARNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 550 N Hillside, Wichita, KS 67214 Phone: 316-962-8580 Fax: 316-962-8581 | |
Ms. Shirley Rae Parish, RN, FNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3620 E Sunnybrook Ln, Suite C, Wichita, KS 67210 Phone: 316-651-0062 | |
Dawn M Schake, ARNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 9350 E 35th St N Ste 101, Wichita, KS 67226 Phone: 316-265-1308 Fax: 316-265-4480 |