Provider Demographics
NPI:1568440204
Name:WARD, AGNES M (ARNP,FNP,CWOCCN)
Entity Type:Individual
Prefix:MRS
First Name:AGNES
Middle Name:M
Last Name:WARD
Suffix:
Gender:F
Credentials:ARNP,FNP,CWOCCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1897
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67201-1897
Mailing Address - Country:US
Mailing Address - Phone:316-268-8131
Mailing Address - Fax:316-291-4788
Practice Address - Street 1:848 N SAINT FRANCIS ST STE 3950
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-3860
Practice Address - Country:US
Practice Address - Phone:316-268-5591
Practice Address - Fax:316-291-7890
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS45467 KS363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSQ23794Medicare UPIN
KS161326Medicare ID - Type UnspecifiedMEDICARE