Individual
JAYNA C HARPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2115 S FREMONT AVE, STE 3050, SPRINGFIELD, MO 65804-2239
(417) 820-3905
(417) 820-3528
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
103115
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437329331
—
MO
05
—
186788758
—
AR
01
—
431560263
TRICARE WEST
—
01
—
P00670961
RAILROAD MEDICARE
—
Enumeration date
03/06/2008
Last updated
11/21/2012
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