MEDICARE: MRS. DAWNAN A ZOGLMAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	376G00000X	Nursing Home Administrator

General Provider Information

NPI Number	:	1033828363
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DAWNAN A ZOGLMAN

Provider Business Mailing Address
First Line	:	721 WOLF ST
Second Line	:
City	:	CHENEY
State	:	KS
Zip	:	67025-8011
Country	:	US
Telephone Number	:	316-300-1771
Fax Number	:

Provider Business Practice Location Address
First Line	:	524 N MAIN ST
Second Line	:
City	:	GARDEN PLAIN
State	:	KS
Zip	:	67050-5005
Country	:	US
Telephone Number	:	316-535-6038
Fax Number	:	316-535-6039

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/15/2022
Last Update Date	:	11/15/2022

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