1720610066 NPI number — MRS. PATRICIA L GUTOWSKI DNP, FNP, APRN-C

Table of content: MRS. PATRICIA L GUTOWSKI DNP, FNP, APRN-C (NPI 1720610066)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720610066 NPI number — MRS. PATRICIA L GUTOWSKI DNP, FNP, APRN-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GUTOWSKI
Provider First Name:
PATRICIA
Provider Middle Name:
L
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
DNP, FNP, APRN-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GUTOWSKI
Provider Other First Name:
PATTI
Provider Other Middle Name:
L.
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1720610066
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/30/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1133 COLLEGE AVE STE B100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MANHATTAN
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66502-2943
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
785-565-9500
Provider Business Mailing Address Fax Number:
785-565-9595

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1133 COLLEGE AVE STE B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MANHATTAN
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66502-2770
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-565-9500
Provider Business Practice Location Address Fax Number:
785-565-9595
Provider Enumeration Date:
02/05/2020

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  13-107053-091 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: 53-80287 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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