Individual
MRS. TOMMI JEAN ALCORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1337 S SAM HOUSTON BLVD, HOUSTON, MO 65483-2046
(417) 967-5435
(417) 967-5503
Mailing address
1337 S SAM HOUSTON BLVD, HOUSTON, MO 65483-2046
(417) 967-5435
(417) 967-5503
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2012042941
MO
363L00000X
Nurse Practitioner
Primary
2019035915
MO
363LF0000X
Family Nurse Practitioner
2019035915
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26D0889777
CLIA
MO
05
—
420075368
—
MO
Enumeration date
08/29/2019
Last updated
11/20/2023
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