Provider Demographics
NPI:1619105731
Name:LOTZ, PAMELA M (ACNS)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:M
Last Name:LOTZ
Suffix:
Gender:F
Credentials:ACNS
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:902 N RIVERSIDE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64507-2566
Mailing Address - Country:US
Mailing Address - Phone:816-271-1301
Mailing Address - Fax:816-271-1263
Practice Address - Street 1:902 NO. RIVERSIDE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:ST. JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64507
Practice Address - Country:US
Practice Address - Phone:816-271-1301
Practice Address - Fax:816-271-1263
Is Sole Proprietor?:No
Enumeration Date:2009-06-26
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO094474364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health