Provider Demographics
NPI:1801859582
Name:HOSFELT, CONNIE G (ARNP)
Entity Type:Individual
Prefix:
First Name:CONNIE
Middle Name:G
Last Name:HOSFELT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:CONNIE
Other - Middle Name:G
Other - Last Name:FORRESTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 47490
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67201-7490
Mailing Address - Country:US
Mailing Address - Phone:316-962-3070
Mailing Address - Fax:316-962-3136
Practice Address - Street 1:850 N. HILLSIDE ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214
Practice Address - Country:US
Practice Address - Phone:316-962-3070
Practice Address - Fax:316-962-3070
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS45633363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS1801859582OtherNPI NUMBER
KS200410410AMedicaid
KSQ36318Medicare UPIN
KS161441Medicare ID - Type Unspecified