Provider Demographics
NPI:1730288861
Name:WOLFE-WAPPELHORST, KATHRYN S (PA-C)
Entity Type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:S
Last Name:WOLFE-WAPPELHORST
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:940 S. ST. FRANCIS
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67211
Mailing Address - Country:US
Mailing Address - Phone:316-264-8974
Mailing Address - Fax:316-262-4938
Practice Address - Street 1:2750 S ROOSEVELT ST
Practice Address - Street 2:HUNTER HEALTH BROOKSIDE CLINIC
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67210-1304
Practice Address - Country:US
Practice Address - Phone:316-652-0152
Practice Address - Fax:316-652-0928
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2013-10-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS15-00496363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100212200BMedicaid
KS6973OtherPREFERRED HEALTH SYSTEMS
KS926677OtherFIRSTGUARD
KS12032897OtherCAQH
KS042387OtherBCBS
KS926677OtherFIRSTGUARD