Individual
JASON FALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
1075 NICHOLS RD, OSAGE BEACH, MO 65065-3093
(573) 302-8000
Mailing address
14 ESSEX CT, CAMDENTON, MO 65020-2339
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2025035513
MO
Other
Enumeration date
09/25/2025
Last updated
09/25/2025
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