NPI 1801522875 · live from the CMS NPI Registry
Katilyn C Broberg, OD
Optometrist in Wichita, KS. National Provider Identifier 1801522875, active.
NPI record
| NPI | 1801522875 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Optometrist 152W00000X |
| Practice location | 2635 W Douglas Ave, Wichita, KS 67213 |
| Practice phone | 316-942-7496 |
| Mailing address | 1652 S Butternut St, Wichita, KS 67230 |
| Enumerated | August 1, 2022 |
| Last updated | August 1, 2022 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist primary | 152W00000X | 2168 (KS) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.