Healthcare Provider Details

I. General information

NPI: 1356260905
Provider Name (Legal Business Name): DODIE JO GREENFIELD FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 SW 29TH ST
TOPEKA KS
66611-1200
US

IV. Provider business mailing address

702 W 2ND
OVERBROOK KS
66524-9390
US

V. Phone/Fax

Practice location:
  • Phone: 785-379-4600
  • Fax: 785-379-4600
Mailing address:
  • Phone: 785-806-2692
  • Fax: 785-379-4630

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number53-85891-092
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number13-74800-092
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: