Connie R White, PA
Individual provider Active NPI Physician Assistant · Haysville, KS
NPI 1942274642 · NPPES record last updated Jun 4, 2009
Key facts
- NPI
- 1942274642
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 1600384 (KS)
- Practice address
- 7030 S Broadway St
Haysville, KS 67060-1471 - Phone
- (316) 469-1099
- Fax
- (316) 469-1098
- NPI assigned
- Feb 17, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1600384 | KS | MD | Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1600384 | KS | Yes |
Addresses
Primary practice location
7030 S Broadway St
Haysville, KS 67060-1471
Mailing address
7030 S Broadway St
Haysville, KS 67060-1471
Phone (316) 469-1099
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200360660A | Medicaid | KS |
Other providers in Haysville, KS
- Michaela Lynn Smith
- Michael Thanh Tran
- Zoe Tyson-Knight
- Tara Wasinger
- Brock A Watson
- Williams Medical Group Practice, LLC
- Carol M Ysidro
All providers in Haysville, KS · Physician Assistant in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 4, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.