MEDICARE: TAMARA HARPER GROSE APRN

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
1	163W00000X	Registered Nurse	129512	KS
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	53-82417-092	KS

General Provider Information

NPI Number	:	1881132496
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMARA HARPER GROSE APRN

Provider Business Mailing Address
First Line	:	2420 N WOODLAWN BLVD STE 300
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67220-3960
Country	:	US
Telephone Number	:	316-347-7157
Fax Number	:

Provider Business Practice Location Address
First Line	:	2420 N WOODLAWN BLVD STE 300
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67220-3960
Country	:	US
Telephone Number	:	316-347-7157
Fax Number	:	316-247-9528

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2017
Last Update Date	:	08/27/2025

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Directions to “ TAMARA HARPER GROSE APRN” Practice Location

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