Provider Demographics
NPI:1740166040
Name:VASQUEZ, KATRINA S (DNP FNP-C)
Entity type:Individual
Prefix:
First Name:KATRINA
Middle Name:S
Last Name:VASQUEZ
Suffix:
Gender:F
Credentials:DNP FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2230 S MILSTEAD ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67209-3607
Mailing Address - Country:US
Mailing Address - Phone:316-871-9275
Mailing Address - Fax:
Practice Address - Street 1:2230 S MILSTEAD ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67209-3607
Practice Address - Country:US
Practice Address - Phone:316-871-9275
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-12
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-84648-122207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine