Individual
JACQUELINE FORNELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, FNP-C
Contact information
Practice address
932 E 34TH ST, JOPLIN, MO 64804-3932
(417) 347-8310
Mailing address
PO BOX 3810, JOPLIN, MO 64803-3810
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2020036180
MO
Other
Enumeration date
12/29/2020
Last updated
09/26/2022
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