Provider Demographics
NPI:1407629983
Name:GOTTSCHE BURNS, LOTTIE (RN)
Entity Type:Individual
Prefix:
First Name:LOTTIE
Middle Name:
Last Name:GOTTSCHE BURNS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3531 WINGATE CIR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-4339
Mailing Address - Country:US
Mailing Address - Phone:907-444-8609
Mailing Address - Fax:
Practice Address - Street 1:2500 MINNESOTA DR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-2384
Practice Address - Country:US
Practice Address - Phone:907-742-5201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK37317163WH0200X, 163WW0000X, 163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WW0000XNursing Service ProvidersRegistered NurseWound Care