Provider Demographics
NPI:1942208376
Name:STREIFF, MARCIA G (APRN, CNM, IBCLC)
Entity Type:Individual
Prefix:
First Name:MARCIA
Middle Name:G
Last Name:STREIFF
Suffix:
Gender:F
Credentials:APRN, CNM, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 S MONTBELLA ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67230-6421
Mailing Address - Country:US
Mailing Address - Phone:316-680-1023
Mailing Address - Fax:
Practice Address - Street 1:128 S MONTBELLA ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67230-6421
Practice Address - Country:US
Practice Address - Phone:316-680-1023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS13-70374-082163WL0100X
187-10242174400000X
L-33851174N00000X
KS75752367A00000X
KS45106363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No174400000XOther Service ProvidersSpecialist
No174N00000XOther Service ProvidersLactation Consultant, Non-RN
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS161376OtherBCBS PROVIDER NUMBER
KS161376OtherBCBS PROVIDER NUMBER
P88373Medicare UPIN