Provider Demographics
NPI:1942493762
Name:VU, VERONICA (PA)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:VU
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:VERONICA
Other - Middle Name:
Other - Last Name:RAMOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:3009 N CYPRESS ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-4003
Mailing Address - Country:US
Mailing Address - Phone:316-440-1010
Mailing Address - Fax:316-440-0802
Practice Address - Street 1:3009 N CYPRESS ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226-4003
Practice Address - Country:US
Practice Address - Phone:316-440-1010
Practice Address - Fax:316-440-0802
Is Sole Proprietor?:No
Enumeration Date:2007-08-24
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS15-01217363AM0700X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
003719074OtherMEDICARE
KS200548890BMedicaid