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Individual

TEDRA E ESTIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DNP, FPMHNP

Contact information

Practice address
323 E GRAND ST, SPRINGFIELD, MO 65807-1447
(417) 761-5600
(417) 761-5601
Mailing address
2885 W BATTLEFIELD ST, SPRINGFIELD, MO 65807-3952

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2016006748
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
420034864
MO
Enumeration date
07/02/2016
Last updated
04/09/2026
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