Provider Demographics
NPI:1225495807
Name:MINJA, ANTHONY D (APRN)
Entity Type:Individual
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First Name:ANTHONY
Middle Name:D
Last Name:MINJA
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Gender:M
Credentials:APRN
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Mailing Address - Street 1:1901 E 1ST ST; PO BOX 467
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:KS
Mailing Address - Zip Code:67114-0467
Mailing Address - Country:US
Mailing Address - Phone:316-284-6400
Mailing Address - Fax:318-284-6490
Practice Address - Street 1:6611 E CENTRAL AVE STE C
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-1937
Practice Address - Country:US
Practice Address - Phone:316-648-1157
Practice Address - Fax:866-316-4467
Is Sole Proprietor?:No
Enumeration Date:2016-01-27
Last Update Date:2022-10-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS77028363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health