Look up the most recent NPI and PECOS records

Angela Kisanko

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

1919 N Amidon Ave, Wichita, KS 67203-2117

(316) 866-2000

PECOS Enrollment

Based on the most recent information from CMS, provider Angela Kisanko is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1447013495
Provider Type
Individual
Full Name
Kisanko, Angela
Credential
APRN-C

Gender
Female
Sole Proprietor
No
Enumeration Date
2/2/2024
Last Updated
2/2/2024

Contact Information

Practice Location

1919 N Amidon Ave, Wichita, KS 67203-2117

(316) 866-2000

Unlisted Fax

Mailing Location

1919 N Amidon Ave, Wichita, KS 67203-2117

(316) 866-2000

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 82819 Kansas

Angela Kisanko

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

M-Care Healthcare Llc

Sanchez, Jennifer Leann

Webb, Micha

Wood, Stacey Lynn

Kaljumaa, Lara Lenea

Kim, Songyeon

Kendall, Roxan A

Hermes, Jayne Lou

Harter, Kristin Michelle

Benvin, Leslie