Provider Demographics
NPI:1386371680
Name:SANSOM, GABRIELLA MARIE (PA-C)
Entity type:Individual
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First Name:GABRIELLA
Middle Name:MARIE
Last Name:SANSOM
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:11010 DELAWARE PKWY APT 3010
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66109-3583
Mailing Address - Country:US
Mailing Address - Phone:816-286-0568
Mailing Address - Fax:
Practice Address - Street 1:17065 S. 71 HIGHWAY
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:MO
Practice Address - Zip Code:64012
Practice Address - Country:US
Practice Address - Phone:816-348-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-05
Last Update Date:2022-08-08
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant