Healthcare Provider Details

I. General information

NPI: 1760800528
Provider Name (Legal Business Name): CARLA GORMAN FRAZIER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CARLA MARIE GORMAN NP

II. Dates (important events)

Enumeration Date: 03/30/2014
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8900 STATE LINE RD STE 380
LEAWOOD KS
66206-1936
US

IV. Provider business mailing address

8900 STATE LINE RD STE 380
LEAWOOD KS
66206-1936
US

V. Phone/Fax

Practice location:
  • Phone: 913-385-7252
  • Fax:
Mailing address:
  • Phone: 913-385-7252
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2014000944
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2022009954
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number76222
License Number StateKS
# 4
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number76222
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: