Provider Demographics
NPI:1376767863
Name:GROENE, CYNTHIA A (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:A
Last Name:GROENE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:818 N EMPORIA ST
Mailing Address - Street 2:STE 403
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67214-3729
Mailing Address - Country:US
Mailing Address - Phone:316-262-4467
Mailing Address - Fax:316-262-0706
Practice Address - Street 1:1305 E 5TH AVE
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:KS
Practice Address - Zip Code:67156-2406
Practice Address - Country:US
Practice Address - Phone:620-221-6125
Practice Address - Fax:620-221-0440
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS74688363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS161372OtherBCBSKS ID NUMBER
KS161372OtherBCBSKS ID NUMBER
KSQ10143Medicare UPIN