Provider Demographics
NPI:1427625185
Name:HINSLEY, D'AMBRA SUZANNE (PA)
Entity type:Individual
Prefix:MRS
First Name:D'AMBRA
Middle Name:SUZANNE
Last Name:HINSLEY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:D'AMBRA
Other - Middle Name:SUZANNE
Other - Last Name:KRUGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6459 N KERMAN DR
Mailing Address - Street 2:
Mailing Address - City:PARK CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67219-1628
Mailing Address - Country:US
Mailing Address - Phone:316-737-9546
Mailing Address - Fax:
Practice Address - Street 1:929 N SAINT FRANCIS AVE
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-3821
Practice Address - Country:US
Practice Address - Phone:316-268-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-09
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
KS1502523363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant