Provider Demographics
NPI:1548235575
Name:POND, PAULA S (APRN)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:S
Last Name:POND
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:S
Other - Last Name:FLOYD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:1035 NORTH EMPORIA, SUITE 105
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67214-2998
Mailing Address - Country:US
Mailing Address - Phone:316-263-7285
Mailing Address - Fax:316-263-2666
Practice Address - Street 1:1035 NORTH EMPORIA, SUITE 105
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-2998
Practice Address - Country:US
Practice Address - Phone:316-263-7285
Practice Address - Fax:316-263-2666
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS44635363L00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS4286017502Medicare ID - Type Unspecified
KS161579Medicare ID - Type Unspecified