Provider Demographics
NPI:1598351728
Name:BANH, ANGELINA A (PHARMD, RPH, BSN, RN)
Entity Type:Individual
Prefix:DR
First Name:ANGELINA
Middle Name:A
Last Name:BANH
Suffix:
Gender:F
Credentials:PHARMD, RPH, BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10405 W 13TH ST N
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67212-5601
Mailing Address - Country:US
Mailing Address - Phone:316-773-9048
Mailing Address - Fax:
Practice Address - Street 1:5500 E KELLOGG DR
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67218-1607
Practice Address - Country:US
Practice Address - Phone:316-685-2221
Practice Address - Fax:316-651-3615
Is Sole Proprietor?:No
Enumeration Date:2020-12-11
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS138046163W00000X
KS1-100885183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No163W00000XNursing Service ProvidersRegistered Nurse