Doctor Name: | ZANDRA GOTTMAN |
NPI Number: | 1235529512 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN |
License Number: | 2015000983 |
Business Practice Address: | 17067 S Outer Rd Ste 100 Belton, MO - 640122165 |
Business Phone Number: | 8163314000 |
Business Fax Number: | 8163313626 |
Mailing Address: | 17067 S Outer Rd, Ste 100 BELTON |
State: | MO |
Postal Code: | 640122165 |
Phone Number: | 8163314000 |
Fax Number: | 8163313626 |
NPI Enumeration Date: | 01/26/2015 |
NPI Last Update Date: | 02/24/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 2015000983 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |