Provider Demographics
NPI:1215575956
Name:STROBLE, MIA DANIELLE (APRN)
Entity Type:Individual
Prefix:
First Name:MIA
Middle Name:DANIELLE
Last Name:STROBLE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2149 DOVE
Mailing Address - Street 2:
Mailing Address - City:LONGTON
Mailing Address - State:KS
Mailing Address - Zip Code:67352-5204
Mailing Address - Country:US
Mailing Address - Phone:620-960-5534
Mailing Address - Fax:
Practice Address - Street 1:300 W NORTH ST
Practice Address - Street 2:
Practice Address - City:SEDAN
Practice Address - State:KS
Practice Address - Zip Code:67361-1051
Practice Address - Country:US
Practice Address - Phone:620-725-3818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-12
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS79146363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS79146OtherKANSAS STATE BOARD OF NURSING