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General NPI Number Information
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NPI Number | 1124686969
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Entity Type | Individual
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Provider Name | JEFFREY GATROST FNP-BC
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Gender | Male
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Dates
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Enumeration Date | 06/05/2019
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Last Update Date | 11/11/2020
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Provider Practice Location Address
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Address Line | 2301 HOLMES ST
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City | KANSAS CITY
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State | MO
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Zip | 64108-2677
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Country | US
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Telephone | 816-404-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 23902 E US HIGHWAY 24
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City | INDEPENDENCE
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State | MO
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Zip | 64056-3983
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Country | US
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Telephone | 816-694-5414
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2019011202
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License Number State | MO
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