Provider Demographics
NPI:1386694297
Name:HAMANN, CHRISTA L (ARNP)
Entity type:Individual
Prefix:
First Name:CHRISTA
Middle Name:L
Last Name:HAMANN
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 929
Mailing Address - Street 2:
Mailing Address - City:CHICKASHA
Mailing Address - State:OK
Mailing Address - Zip Code:73023-0929
Mailing Address - Country:US
Mailing Address - Phone:316-616-1055
Mailing Address - Fax:855-633-0585
Practice Address - Street 1:530 N RIDGE RD STE B
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67212-6576
Practice Address - Country:US
Practice Address - Phone:316-616-1055
Practice Address - Fax:855-633-0585
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS45121363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100428040FMedicaid