Individual
VALARIE DIANE GREENLEAF-KISNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD, LD,CDCES
Contact information
Practice address
9415 E HARRY ST STE 407, WICHITA, KS 67207-5083
(316) 253-2604
(316) 634-3789
Mailing address
12210 E BOXTHORN ST, WICHITA, KS 67226-8263
(316) 253-2604
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
00047
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100210590F
—
KS
01
—
130432
BLUECROSS BLUE SHIELD
KS
Enumeration date
10/20/2006
Last updated
09/20/2021
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