Individual
RAE STITES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3333 MCINTOSH CIR STE 1, JOPLIN, MO 64804-3681
(417) 347-8055
Mailing address
PO BOX 3810, JOPLIN, MO 64803-3810
(417) 347-3474
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2014044286
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2500074246
BNDD
MO
Enumeration date
01/05/2015
Last updated
07/02/2024
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