Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife |
NPI | 1104010925 |
---|---|
Provider Name | Cheryl Renee Gates |
First Address | Overland Park, KS 66210-2761 |
Second Address | Overland Park, KS 66210-2761 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2007 |
Last Update Date | 05/09/2007 |