Provider Demographics
NPI:1477517696
Name:HINDS, KATRINA N (PA-C)
Entity type:Individual
Prefix:
First Name:KATRINA
Middle Name:N
Last Name:HINDS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KATRINA
Other - Middle Name:N
Other - Last Name:STEPHENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8725 E 32ND ST N
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-4008
Mailing Address - Country:US
Mailing Address - Phone:316-201-1202
Mailing Address - Fax:316-201-1251
Practice Address - Street 1:7570 W 21ST ST N STE 1006B
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67205-1773
Practice Address - Country:US
Practice Address - Phone:316-201-1202
Practice Address - Fax:316-201-1251
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1500731363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS103702OtherMONTOYA FAMILY PRACTICE GROUP
KS200000970AMedicaid
042035Medicare ID - Type Unspecified