NPI | 1295471811 |
---|---|
Entity Type | Organization |
Authorized Contact | MICHELLE COOLEY Supervisor Credentialing And Billin 417-989-0140 |
Organization Subpart ? | No |
Primary Taxonomy | 261QI0500X Clinic/Center, Infusion Therapy |
Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology |
261Q00000X Clinic/Center | |
363LF0000X Nurse Practitioner, Family | |
Enumeration Date | 2022-05-06 |
Last Update Date | 2025-04-17 |