Provider Demographics
NPI:1629366349
Name:GREENFIELD, AMY SUE (ARNP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:SUE
Last Name:GREENFIELD
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:SUE
Other - Last Name:MELLIES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:DEPT CH 14389
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60055-4389
Mailing Address - Country:US
Mailing Address - Phone:785-295-5307
Mailing Address - Fax:785-270-7646
Practice Address - Street 1:1700 SW 7TH STREET
Practice Address - Street 2:2ND FLOOR
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66606-1690
Practice Address - Country:US
Practice Address - Phone:785-295-7800
Practice Address - Fax:785-231-5990
Is Sole Proprietor?:No
Enumeration Date:2011-07-15
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS13-81069163W00000X
KS53-75463363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200738890AMedicaid
KS068002141OtherMEDICARE PTAN