Basic Information
| Provider Information | |||||||||
| NPI: | 1629366349 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GREENFIELD | ||||||||
| FirstName: | AMY | ||||||||
| MiddleName: | SUE | ||||||||
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| Credential: | ARNP | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | MELLIES | ||||||||
| OtherFirstName: | AMY | ||||||||
| OtherMiddleName: | SUE | ||||||||
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| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | DEPT CH 14389 | ||||||||
| Address2: | |||||||||
| City: | PALATINE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600554389 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7852955307 | ||||||||
| FaxNumber: | 7852707646 | ||||||||
| Practice Location | |||||||||
| Address1: | 1700 SW 7TH STREET | ||||||||
| Address2: | 2ND FLOOR | ||||||||
| City: | TOPEKA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 666061690 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7852957800 | ||||||||
| FaxNumber: | 7852315990 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/15/2011 | ||||||||
| LastUpdateDate: | 02/28/2014 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 13-81069 | KS | N | Nursing Service Providers | Registered Nurse | 363L00000X | 53-75463 | KS | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.