Healthcare Provider Details

I. General information

NPI: 1942208376
Provider Name (Legal Business Name): MARCIA G STREIFF APRN, CNM, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2005
Last Update Date: 03/07/2023
Certification Date: 05/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

128 S MONTBELLA ST
WICHITA KS
67230-6421
US

IV. Provider business mailing address

128 S MONTBELLA ST
WICHITA KS
67230-6421
US

V. Phone/Fax

Practice location:
  • Phone: 316-680-1023
  • Fax:
Mailing address:
  • Phone: 316-680-1023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number13-70374-082
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number187-10242
License Number State
# 3
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License NumberL-33851
License Number State
# 4
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number75752
License Number StateKS
# 5
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number45106
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: