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NPI Code Detail

MEDICARE: KELLY MARIE GROW

MEDICARE: KELLY MARIE GROW
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
1104100000XSocial WorkerLMSW14394KS

General Provider Information

NPI Number : 1710841077
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLY MARIE GROW
Provider Business Mailing Address
First Line : 810 RUNNING HORSE LN
Second Line :
City : ARKANSAS CITY
State : KS
Zip : 67005-9391
Country : US
Telephone Number : 620-218-1885
Fax Number :
Provider Business Practice Location Address
First Line : 345 N RIVERVIEW ST STE 730
Second Line :
City : WICHITA
State : KS
Zip : 67203-4267
Country : US
Telephone Number : 316-202-2110
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2025
Last Update Date : 12/11/2025

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Directions to “ KELLY MARIE GROW ” Practice Location

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