Provider Demographics
NPI:1689313876
Name:AZZARITO, ANGELA CHRISTINE (MSN-FNP)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:CHRISTINE
Last Name:AZZARITO
Suffix:
Gender:F
Credentials:MSN-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3223 N WEBB RD STE 1
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-8176
Mailing Address - Country:US
Mailing Address - Phone:316-609-2600
Mailing Address - Fax:316-609-2800
Practice Address - Street 1:3223 N WEBB RD STE 1
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226-8176
Practice Address - Country:US
Practice Address - Phone:316-609-2600
Practice Address - Fax:316-609-2800
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-03
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-81227-091363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty