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Registrant NPI Number: 1346657145

Individual Registrant:
Gender: F
Not Sole Proprietor

Location and contact information for practice:
Tel: 417-859-4878  Fax: 417-859-0889

Contact information for business:
Tel: 417-859-4878  Fax: 417-859-0889

Registration Information:
NPI: 1346657145
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N163W00000XNursing Service Providers
Registered Nurse
Y363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner

Legacy codes, insurance codes and state license numbers:



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