Gottuso, Brenda S

Gottuso, Brenda S is an individual health care provider with primary practice located at 2175 Charbonier Rd Suite B, Florissant MO 63031-5500. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Gottuso, Brenda S can be contacted via phone (314) 831-0181.

Contact Information

Primary practice address
2175 Charbonier Rd Suite B Florissant MO 63031-5500
Phone: (314) 831-0181
Fax: (314) 851-4471
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 092325 Missouri

Profile Details

NPI number 1902846694
LBN Legal business name Gottuso, Brenda S
Credentials Adult Nurse Practitioner (ANP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 8th, 2006
Last updated Jan 31st, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902846694 NPPES
Missouri MEDICAID 420126401

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