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NPI Code Detail

MEDICARE: ERICA A GORMAN MSN, APRN, FNP-C

MEDICARE: ERICA A GORMAN MSN, APRN, FNP-C
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
1363LF0000XFamily Nurse Practitioner2017007854MO

General Provider Information

NPI Number : 1184155236
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERICA A GORMAN MSN, APRN, FNP-C
Provider Business Mailing Address
First Line : 901 E 104TH ST
Second Line :
City : KANSAS CITY
State : MO
Zip : 64131-4517
Country : US
Telephone Number : 816-502-8752
Fax Number : 816-932-9670
Provider Business Practice Location Address
First Line : 600 NE ADAMS DAIRY PKWY
Second Line :
City : BLUE SPRINGS
State : MO
Zip : 64014-5493
Country : US
Telephone Number : 816-246-4302
Fax Number : 816-246-9493
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2017
Last Update Date : 09/23/2019

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