Individual
OANH NGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
3527 W TRUMAN BLVD STE 100A, JEFFERSON CITY, MO 65109-5902
(573) 882-8910
(573) 893-1984
Mailing address
PO BOX 843966, KANSAS CITY, MO 64184-3966
(573) 884-3300
(573) 884-0943
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2025028305
MO
Other
Enumeration date
07/11/2025
Last updated
04/28/2026
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