Individual
MS. PHYLLIS JEAN HARTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
440 E TAMPA ST, SPRINGFIELD, MO 65806-1131
(417) 831-0150
(417) 831-0155
Mailing address
PO BOX 5681, SPRINGFIELD, MO 65801-5681
(417) 831-0150
(417) 831-0155
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
063773
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
424657633
—
MO
Enumeration date
08/30/2006
Last updated
03/30/2011
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