Provider Demographics
NPI:1811940505
Name:CARSON, SYLVIA A (ARNP)
Entity type:Individual
Prefix:
First Name:SYLVIA
Middle Name:A
Last Name:CARSON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 47530
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67201-7530
Mailing Address - Country:US
Mailing Address - Phone:316-962-3150
Mailing Address - Fax:316-962-7334
Practice Address - Street 1:3243 E MURDOCK ST
Practice Address - Street 2:LEVEL A
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67208-3052
Practice Address - Country:US
Practice Address - Phone:316-962-3100
Practice Address - Fax:316-962-3164
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS44040363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS657160OtherFIRSTGUARD
KS160766OtherBCBS OF KANSAS
KS657160OtherFIRSTGUARD
KS160766Medicare ID - Type Unspecified