Basic Information
| Provider Information | |||||||||
| NPI: | 1063898823 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WOODARD | ||||||||
| FirstName: | SYLVIA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1721 EILEEN ST | ||||||||
| Address2: | |||||||||
| City: | GARDEN PLAIN | ||||||||
| State: | KS | ||||||||
| PostalCode: | 670509159 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3162077617 | ||||||||
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| Practice Location | |||||||||
| Address1: | 929 N SAINT FRANCIS ST | ||||||||
| Address2: | |||||||||
| City: | WICHITA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 672143821 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3162685000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/04/2015 | ||||||||
| LastUpdateDate: | 08/04/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 76863 | KS | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.