Individual
MS. MELISSA ANN POTTEBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN
Contact information
Practice address
5844 NW BARRY RD, STE 110, KANSAS CITY, MO 64154-1465
(816) 880-6100
(816) 746-1226
Mailing address
901 E. 104TH ST., MAILSTOP 400N, KANSAS CITY, MO 64131
(816) 502-7104
(816) 932-9670
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
145067
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1518299973
—
MO
Enumeration date
02/09/2010
Last updated
02/07/2018
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