Individual
MS. DEANNA M TWYMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, BC, FNP
Contact information
Practice address
301 SOUTH NEWPORT AVENUE, CONWAY, MO 65632
(417) 589-2050
(417) 589-4046
Mailing address
PO BOX 9, CONWAY, MO 65632-0009
(417) 589-2050
(417) 589-4046
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN081602
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107004
BLUE CROSS BLUE SHIELD
MO
05
—
598899201
—
MO
01
—
A002
TRI CARE IDENTIFIER
—
01
—
RN081602
STATE LICENSE
MO
Enumeration date
12/20/2005
Last updated
05/15/2014
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