Individual
JAMA JELAINE BOGART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
345 S BARRETT LN, NEVADA, MO 64772-4255
(417) 448-2439
(417) 549-6112
Mailing address
800 S ASH ST, NEVADA, MO 64772-3223
(417) 448-3600
(417) 448-3796
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
106090
MO
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
2021050610
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1801972682
—
MO
Enumeration date
10/27/2006
Last updated
12/30/2021
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