Provider Demographics
NPI:1609969757
Name:CHILDS, BELINDA L (ARNP, CDE)
Entity Type:Individual
Prefix:
First Name:BELINDA
Middle Name:L
Last Name:CHILDS
Suffix:
Gender:F
Credentials:ARNP, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:834 N SOCORA ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67212-3279
Mailing Address - Country:US
Mailing Address - Phone:316-440-2802
Mailing Address - Fax:316-440-2809
Practice Address - Street 1:834 N SOCORA ST
Practice Address - Street 2:SUITE 4
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67212
Practice Address - Country:US
Practice Address - Phone:316-440-2802
Practice Address - Fax:316-440-2809
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2018-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS74249364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSCU0422OtherMEDICARE RAILROAD GROUP
KS100290730AMedicaid
KS100290730AMedicaid
KSCU0422OtherMEDICARE RAILROAD GROUP