Active NPI
Andrea Stafford
- Adult Health Nurse Practitioner
- Wichita, KS
National Provider Identifier
1013494467
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 78296
- Practice address
- 1491 N Coolidge Ave
Wichita, KS 67203-2982 - Phone
- (316) 737-5425
- NPI assigned
- Jul 27, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 78296 | KS | Primary |
Addresses
Primary practice location
1491 N Coolidge Ave
Wichita, KS 67203-2982
Mailing address
1491 N Coolidge Ave
Wichita, KS 67203-2982
Phone (316) 737-5425
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 78296 | KS | MD | Adult Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1532649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1532649600000",
"number": "1013494467",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1491 N COOLIDGE AVE",
"city": "WICHITA",
"state": "KS",
"postal_code": "672032982",
"telephone_number": "316-737-5425"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1491 N COOLIDGE AVE",
"city": "WICHITA",
"state": "KS",
"postal_code": "672032982",
"telephone_number": "316-737-5425"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAFFORD",
"first_name": "ANDREA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-07-27",
"last_updated": "2018-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "KS",
"license": "78296",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wichita, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.