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General NPI Number Information
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NPI Number | 1932505054
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Entity Type | Individual
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Provider Name | SAMUEL GOETSCHIUS APRN
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Gender | Male
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Dates
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Enumeration Date | 11/17/2014
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Last Update Date | 12/26/2025
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Provider Practice Location Address
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Address Line | 7300 W 110TH ST STE 700
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City | OVERLAND PARK
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State | KS
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Zip | 66210-2332
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Country | US
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Telephone | 620-704-0224
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Fax |
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Provider Business Mailing Address
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Address Line | 3311 YELLOWSTAR ST
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City | GARDEN CITY
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State | KS
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Zip | 67846-6992
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Country | US
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Telephone | 913-295-0501
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Fax | 620-634-0765
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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 | 53-76527-011
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 76527
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License Number State | KS
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