Healthcare Provider Details

I. General information

NPI: 1720610066
Provider Name (Legal Business Name): PATRICIA L GUTOWSKI DNP, FNP, APRN-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MRS. PATTI L. GUTOWSKI

II. Dates (important events)

Enumeration Date: 02/05/2020
Last Update Date: 08/30/2021
Certification Date: 08/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1133 COLLEGE AVE STE B
MANHATTAN KS
66502-2770
US

IV. Provider business mailing address

1133 COLLEGE AVE STE B100
MANHATTAN KS
66502-2943
US

V. Phone/Fax

Practice location:
  • Phone: 785-565-9500
  • Fax: 785-565-9595
Mailing address:
  • Phone: 785-565-9500
  • Fax: 785-565-9595

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number13-107053-091
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number53-80287
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: