Individual
BRENDA M. CUPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
100 MERCY WAY, SUITE 320-330, JOPLIN, MO 64804-4524
(417) 781-5387
(417) 781-7174
Mailing address
100 MERCY WAY, SUITE 320-330, JOPLIN, MO 64804-4524
(417) 781-5387
(417) 781-7174
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
123412
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200096720A
—
OK
05
—
200406720B
—
KS
05
—
424021004
—
MO
Enumeration date
10/11/2006
Last updated
11/17/2017
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