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Individual

CELESTE DELAINE GROTHUSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN, FNP-C

Contact information

Practice address
3510 N RIDGE RD STE 100, WICHITA, KS 67205-1210
(316) 269-3223
(316) 269-3328
Mailing address
3510 N RIDGE RD STE 100, WICHITA, KS 67205-1210
(316) 269-3223
(316) 269-3328

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
78246
KS
363LF0000X
Family Nurse Practitioner
78246
KS

Other

Enumeration date
07/17/2018
Last updated
07/17/2018
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