Provider Demographics
NPI:1235773383
Name:MUNRO, CONNIE SUE (RN)
Entity Type:Individual
Prefix:
First Name:CONNIE
Middle Name:SUE
Last Name:MUNRO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9415 E HARRY ST STE 800
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67207-5084
Mailing Address - Country:US
Mailing Address - Phone:316-652-2590
Mailing Address - Fax:316-652-2595
Practice Address - Street 1:9415 E HARRY ST STE 800
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67207-5084
Practice Address - Country:US
Practice Address - Phone:316-652-2590
Practice Address - Fax:316-652-2595
Is Sole Proprietor?:No
Enumeration Date:2019-11-01
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-128795-111163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health