Basic Information
| Provider Information | |||||||||
| NPI: | 1023760832 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BROWN | ||||||||
| FirstName: | CHRISTINA | ||||||||
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| Credential: | PNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15603 W MCCORMICK AVE | ||||||||
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| City: | GODDARD | ||||||||
| State: | KS | ||||||||
| PostalCode: | 670525211 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7073656188 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3243 E MURDOCK ST STE 510 | ||||||||
| Address2: | |||||||||
| City: | WICHITA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 672083007 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3169622080 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/23/2022 | ||||||||
| LastUpdateDate: | 01/23/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/23/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080P0207X | 53-80728-111 | KS | Y | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Hematology-Oncology |
No ID Information.