Healthcare Provider Details

I. General information

NPI: 1790780807
Provider Name (Legal Business Name): NANCY N. GILMORE-CASHERO ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2005
Last Update Date: 09/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 W PINE ST
COLUMBUS KS
66725-1705
US

IV. Provider business mailing address

120 W PINE ST
COLUMBUS KS
66725-1705
US

V. Phone/Fax

Practice location:
  • Phone: 620-429-2101
  • Fax: 620-429-2106
Mailing address:
  • Phone: 620-429-2101
  • Fax: 620-429-2106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number45331
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: