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NPI Code Detail

MEDICARE: KATHLEEN A KOTTAS ARNP

MEDICARE: KATHLEEN A KOTTAS ARNP
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 Practitioner44789KS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1044948OTHERKSBLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1952302226
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN A KOTTAS ARNP
Provider Business Mailing Address
First Line : 1309 POLK ST
Second Line :
City : GREAT BEND
State : KS
Zip : 67530-3618
Country : US
Telephone Number : 620-792-5341
Fax Number : 620-792-3702
Provider Business Practice Location Address
First Line : 1309 POLK ST
Second Line :
City : GREAT BEND
State : KS
Zip : 67530-3618
Country : US
Telephone Number : 620-792-5341
Fax Number : 620-792-3702
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2005
Last Update Date : 05/23/2012

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