Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 2017031185 | MO |
NPI | 1306502471 |
---|---|
Provider Name | Andria Elizabeth Ortiz |
First Address | Kansas City, MO 64145-1781 |
Second Address | Kansas City, MO 64145-1781 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/11/2021 |
Last Update Date | 12/11/2021 |