Provider Demographics
NPI:1205355385
Name:ARMSTEAD, CODIE MARIE (PA-C)
Entity type:Individual
Prefix:
First Name:CODIE
Middle Name:MARIE
Last Name:ARMSTEAD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10100 E SHANNON WOODS CIR STE 100
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-4106
Mailing Address - Country:US
Mailing Address - Phone:316-219-8299
Mailing Address - Fax:
Practice Address - Street 1:10100 E SHANNON WOODS CIR STE 100
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226-4106
Practice Address - Country:US
Practice Address - Phone:316-219-8299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-11
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS15-02022363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant