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NPI Code Detail

MEDICARE: TRENA CANTRELL

MEDICARE: TRENA CANTRELL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse13-117895-052KS

General Provider Information

NPI Number : 1679436018
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRENA CANTRELL
Provider Business Mailing Address
First Line : 5500 E KELLOGG DR
Second Line :
City : WICHITA
State : KS
Zip : 67218-1607
Country : US
Telephone Number : 316-685-2221
Fax Number :
Provider Business Practice Location Address
First Line : 5500 E KELLOGG DR
Second Line :
City : WICHITA
State : KS
Zip : 67218-1607
Country : US
Telephone Number : 316-685-2221
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/03/2025
Last Update Date : 12/03/2025

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Directions to “ TRENA CANTRELL ” Practice Location

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