Individual
FATTEN K ELKOMY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNS, FMHNP-BC
Contact information
Practice address
3401 BERRYWOOD DR, COLUMBIA, MO 65201-8372
(573) 777-8330
(573) 777-8330
Mailing address
2885 W BATTLEFIELD ST, SPRINGFIELD, MO 65807-3952
(417) 761-5214
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2013024819
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316388754
—
MO
Enumeration date
07/15/2013
Last updated
07/10/2025
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