Individual
TABATHA RENEE LUNEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2115 S FREMONT AVE, SUITE 5000, SPRINGFIELD, MO 65804-2239
(417) 820-3960
(417) 820-3966
Mailing address
PO BOX 802843, KANSAS CITY, MO 64180-2843
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2013008754
MO
363A00000X
Physician Assistant
PA-617
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
431560263
TRICARE
MO
Enumeration date
03/19/2013
Last updated
05/19/2025
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