MEDICARE: MARCIA G STREIFF APRN, CNM, IBCLC

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	163WL0100X	Lactation Consultant (Registered Nurse)	13-70374-082	KS
2	174400000X	Specialist	187-10242
3	174N00000X	Lactation Consultant (Non-RN)	L-33851
4	367A00000X	Advanced Practice Midwife	75752	KS
5	363LF0000X	Family Nurse Practitioner	45106	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	161376	OTHER	KS	BCBS PROVIDER NUMBER

General Provider Information

NPI Number	:	1942208376
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARCIA G STREIFF APRN, CNM, IBCLC

Provider Business Mailing Address
First Line	:	128 S MONTBELLA ST
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67230-6421
Country	:	US
Telephone Number	:	316-680-1023
Fax Number	:

Provider Business Practice Location Address
First Line	:	128 S MONTBELLA ST
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67230-6421
Country	:	US
Telephone Number	:	316-680-1023
Fax Number	:

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

Provider Enumeration Date	:	07/10/2005
Last Update Date	:	03/07/2023

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