Individual
MS. ELLEN BIVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
312 N KENTUCKY ST, WEST PLAINS, MO 65775-2073
(417) 257-7076
(417) 257-1417
Mailing address
312 N KENTUCKY ST, WEST PLAINS, MO 65775-2073
(417) 257-7076
(417) 257-1417
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
120310
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202169405
—
MO
Enumeration date
07/07/2005
Last updated
11/01/2011
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