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Individual

GRACE C. GAMMON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
9400 E 350, RAYTOWN, MO 64133-6509
(816) 251-5700
(816) 251-5701
Mailing address
901 E 104TH ST, MAILSTOP 400N, KANSAS CITY, MO 64131-4517
(816) 502-7000
(816) 932-9670

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
091419
MO
363LF0000X
Family Nurse Practitioner
53-75377
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
091419
LICENSE
MO
Enumeration date
07/10/2008
Last updated
06/27/2016
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