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NPI 1295100105

NPI 1295100105 : MELISSA OTT NP-C : WESTWOOD, KS

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General NPI Number Information
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    NPI Number           |    1295100105
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    Entity Type          |    Individual 
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    Provider Name        |    MELISSA OTT NP-C
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    12/02/2015
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    Last Update Date     |    12/02/2015
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Provider Practice Location Address
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    Address Line         |    1900 W 47TH PL SUITE 400
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    City                 |    WESTWOOD
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    State                |    KS
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    Zip                  |    66205-1815
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    Country              |    US
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    Telephone            |    913-261-6164
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    Fax                  |    913-261-6464
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Provider Business Mailing Address
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    Address Line         |    1900 W 47TH PL SUITE 400
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    City                 |    WESTWOOD
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    State                |    KS
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    Zip                  |    66205-1815
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    Country              |    US
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    Telephone            |    913-261-6164
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    Fax                  |    913-261-6464
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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       |    53-77050-052
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    License Number State |    KS
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