Provider Demographics
NPI:1235529512
Name:GOTTMAN, ZANDRA (APRN)
Entity Type:Individual
Prefix:
First Name:ZANDRA
Middle Name:
Last Name:GOTTMAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17067 S OUTER RD
Mailing Address - Street 2:STE 100
Mailing Address - City:BELTON
Mailing Address - State:MO
Mailing Address - Zip Code:64012-2165
Mailing Address - Country:US
Mailing Address - Phone:816-331-4000
Mailing Address - Fax:816-331-3626
Practice Address - Street 1:4200 REGENT ST STE 200
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219-6229
Practice Address - Country:US
Practice Address - Phone:877-870-1775
Practice Address - Fax:614-968-8840
Is Sole Proprietor?:No
Enumeration Date:2015-01-26
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015000983363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily