Individual
KATHLEEN A KOTTAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1309 POLK ST, GREAT BEND, KS 67530-3618
(620) 792-5341
(620) 792-3702
Mailing address
1309 POLK ST, GREAT BEND, KS 67530-3618
(620) 792-5341
(620) 792-3702
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
44789
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
044948
BLUE SHIELD
KS
05
—
100254730A
—
KS
Enumeration date
08/09/2005
Last updated
05/23/2012
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