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Individual

MRS. JAMIE M BOATMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
9100 W 74TH ST, SHAWNEE MISSION, KS 66204-4004
(913) 676-2679
Mailing address
9100 W 74TH ST, SHAWNEE MISSION, KS 66204-4004
(913) 676-2679

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
92065
KS
363LG0600X
Gerontology Nurse Practitioner
Primary
45924
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200406310A
KS
01
P00355845
RR MEDICARE
KS
Enumeration date
09/29/2006
Last updated
12/09/2009
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