Individual
SUSAN M KLOTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
609 E WELLS ST STE B, ASH GROVE, MO 65604-9087
(417) 234-3621
(949) 655-7855
Mailing address
12374 W FARM ROAD 60, ASH GROVE, MO 65604-8766
(417) 234-3621
(949) 655-7855
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2013012284
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1033555933
—
MO
Enumeration date
05/17/2013
Last updated
07/29/2020
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