Provider Demographics
NPI:1538126594
Name:STRONG, THERESA A (ARNP)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:A
Last Name:STRONG
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 SW LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66606-1515
Mailing Address - Country:US
Mailing Address - Phone:785-231-0603
Mailing Address - Fax:785-233-1404
Practice Address - Street 1:2830 SW URISH RD
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66614-5614
Practice Address - Country:US
Practice Address - Phone:785-273-4010
Practice Address - Fax:785-233-1404
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2009-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS74236363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100337090AMedicaid
S71136Medicare UPIN
KS160200Medicare ID - Type Unspecified