Provider Demographics
NPI:1194092262
Name:GATZ, JUANITA M (ARNP)
Entity type:Individual
Prefix:MRS
First Name:JUANITA
Middle Name:M
Last Name:GATZ
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:350 S RANGE AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:COLBY
Mailing Address - State:KS
Mailing Address - Zip Code:67701-2958
Mailing Address - Country:US
Mailing Address - Phone:785-460-4596
Mailing Address - Fax:785-460-4595
Practice Address - Street 1:350 S RANGE AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:COLBY
Practice Address - State:KS
Practice Address - Zip Code:67701-2958
Practice Address - Country:US
Practice Address - Phone:785-460-4596
Practice Address - Fax:785-460-4595
Is Sole Proprietor?:No
Enumeration Date:2011-11-17
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS53-74231-082364SC1501X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SC1501XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistCommunity Health/Public Health