Individual
CARLA K. ATHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
3231 S NATIONAL AVE, SUITE 300, SPRINGFIELD, MO 65807-7304
(417) 841-0285
(417) 841-0286
Mailing address
PO BOX 505164, SAINT LOUIS, MO 63150-5164
(417) 829-4620
(417) 829-4316
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2015019756
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134501695
—
MO
Enumeration date
06/22/2015
Last updated
10/15/2015
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