Provider Demographics
NPI:1942533831
Name:GILCHRIST, ANJA K (PA)
Entity Type:Individual
Prefix:
First Name:ANJA
Middle Name:K
Last Name:GILCHRIST
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:ANJA
Other - Middle Name:K
Other - Last Name:TALLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:PO BOX 8035
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67208-0035
Mailing Address - Country:US
Mailing Address - Phone:316-268-5178
Mailing Address - Fax:316-719-3196
Practice Address - Street 1:1947 N FOUNDERS CIR
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-3548
Practice Address - Country:US
Practice Address - Phone:316-274-4680
Practice Address - Fax:316-613-4940
Is Sole Proprietor?:No
Enumeration Date:2009-09-10
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1501327363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant