=====================================================
General NPI Number Information
=====================================================
NPI Number | 1316819188
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SIERRA CHEYENNE MUNGER
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/22/2025
-----------------------------------------------------
Last Update Date | 09/22/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 345 N RIVERVIEW ST STE 730
-----------------------------------------------------
City | WICHITA
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 67203-4267
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 316-202-2110
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 325 E 10TH ST
-----------------------------------------------------
City | NEWTON
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 67114-1825
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 316-315-9076
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | 14419
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------