Provider Demographics
NPI:1609168525
Name:KOITA, ARLINDA KAY (PA)
Entity Type:Individual
Prefix:
First Name:ARLINDA
Middle Name:KAY
Last Name:KOITA
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:ARLINDA
Other - Middle Name:KAY
Other - Last Name:SPELLNEIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6544 W 51ST ST
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66202-1734
Mailing Address - Country:US
Mailing Address - Phone:913-636-8683
Mailing Address - Fax:
Practice Address - Street 1:6544 W 51ST ST
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:KS
Practice Address - Zip Code:66202-1734
Practice Address - Country:US
Practice Address - Phone:913-636-8683
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-11
Last Update Date:2015-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS15-01448363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200739450BMedicaid
KS139000135Medicare PIN