Provider Demographics
NPI:1275392342
Name:NDUNGU, EMMA A
Entity Type:Individual
Prefix:DR
First Name:EMMA
Middle Name:A
Last Name:NDUNGU
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:EMMA
Other - Middle Name:A
Other - Last Name:ODUKA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN
Mailing Address - Street 1:1152 N LINDEN CIR
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-4084
Mailing Address - Country:US
Mailing Address - Phone:316-992-2331
Mailing Address - Fax:
Practice Address - Street 1:7607 E HARRY ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67207-3111
Practice Address - Country:US
Practice Address - Phone:316-869-0015
Practice Address - Fax:316-618-0414
Is Sole Proprietor?:No
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-82936-061363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily