| Citizens Memorial Healthcare | |
|
1500 N Oakland Ave Bolivar MO 65613-3011 | |
| (417) 326-6000 | |
| (417) 328-6242 |
| Full Name | Citizens Memorial Healthcare |
|---|---|
| Speciality | Surgery |
| Location | 1500 N Oakland Ave, Bolivar, Missouri |
| Authorized Official Name and Position | Donald J Babb (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 4173286501 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Citizens Memorial Healthcare 1500 N Oakland Ave Bolivar MO 65613-3011 Ph: (417) 328-6501 | Citizens Memorial Healthcare 1500 N Oakland Ave Bolivar MO 65613-3011 Ph: (417) 326-6000 |
| NPI Number | 1568566131 |
|---|---|
| Provider Enumeration Date | 09/12/2006 |
| Last Update Date | 01/05/2017 |
| Medicare PECOS PAC ID | 4183528169 |
|---|---|
| Medicare Enrollment ID | O20040315001374 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568566131 | NPI | - | NPPES |
| Provider Name | Candi D Erven |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780752592 PECOS PAC ID: 4981508991 Enrollment ID: I20031121000347 |
| Provider Name | John S Swango |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1013904150 PECOS PAC ID: 8820992704 Enrollment ID: I20031121000655 |
| Provider Name | Mark J Bult |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1326014945 PECOS PAC ID: 6608761812 Enrollment ID: I20040217000805 |
| Provider Name | Mark R Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568486850 PECOS PAC ID: 6901894682 Enrollment ID: I20040503000581 |
| Provider Name | Donald K Wantuck |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1841480316 PECOS PAC ID: 7315855756 Enrollment ID: I20040504001252 |
| Provider Name | Sean R Larimore |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689655441 PECOS PAC ID: 8022009448 Enrollment ID: I20040524000179 |
| Provider Name | Brent A Bartgis |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1518062215 PECOS PAC ID: 8921086760 Enrollment ID: I20040709000090 |
| Provider Name | Robert D Forsyth |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1023173754 PECOS PAC ID: 1052383957 Enrollment ID: I20040811000388 |
| Provider Name | Eric J Fulnecky |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1922176635 PECOS PAC ID: 7618940610 Enrollment ID: I20040818000000 |
| Provider Name | Stephen Kuehn |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1750317533 PECOS PAC ID: 7315911799 Enrollment ID: I20040823000205 |
| Provider Name | Anne E Winkler |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1346307220 PECOS PAC ID: 2466413455 Enrollment ID: I20041022000716 |
| Provider Name | Harvey Serota |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1346264017 PECOS PAC ID: 2163325572 Enrollment ID: I20041106000131 |
| Provider Name | David B Rogers |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1790766558 PECOS PAC ID: 4688625882 Enrollment ID: I20050204000478 |
| Provider Name | Shawn F Brigance |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205816949 PECOS PAC ID: 0446297733 Enrollment ID: I20050408000093 |
| Provider Name | John F Best |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1154373462 PECOS PAC ID: 7315986320 Enrollment ID: I20050428001064 |
| Provider Name | Angela Olomon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487618062 PECOS PAC ID: 1456313311 Enrollment ID: I20050512000429 |
| Provider Name | Dana M Meents |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1861448854 PECOS PAC ID: 9739075813 Enrollment ID: I20050518000102 |
| Provider Name | Sudhir Batchu |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1871698662 PECOS PAC ID: 5799729570 Enrollment ID: I20050630000220 |
| Provider Name | Anthony T Tay |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1669416046 PECOS PAC ID: 4688604911 Enrollment ID: I20050817000031 |
| Provider Name | Mark Jarek |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1013955541 PECOS PAC ID: 6406886209 Enrollment ID: I20050820000070 |
| Provider Name | Suckhong Brian Kim |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1922041839 PECOS PAC ID: 2163452970 Enrollment ID: I20050820000130 |
| Provider Name | John C Crighton |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1891895553 PECOS PAC ID: 0840222642 Enrollment ID: I20050901000017 |
| Provider Name | Sherrie Ament-sturtevant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396769766 PECOS PAC ID: 8123051273 Enrollment ID: I20050919000145 |
| Provider Name | Curtis P Schreiber |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1962461939 PECOS PAC ID: 4789608712 Enrollment ID: I20060118000159 |
| Provider Name | George W Mathews |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1619980919 PECOS PAC ID: 2769490929 Enrollment ID: I20060329000545 |
| Provider Name | Joseph Horner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1215986948 PECOS PAC ID: 8729090824 Enrollment ID: I20060607000167 |
| Provider Name | Mary L Hogan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932147808 PECOS PAC ID: 8123031648 Enrollment ID: I20060728000047 |
| Provider Name | Mark J Walterskirchen |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1083637524 PECOS PAC ID: 2466455308 Enrollment ID: I20060816000134 |
| Provider Name | Ronda S Entlicher Stewart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740262278 PECOS PAC ID: 3678577939 Enrollment ID: I20060830000016 |
| Provider Name | Joseph Follis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780666214 PECOS PAC ID: 4688677131 Enrollment ID: I20060830000019 |
| Provider Name | Walter Wayne Wolf |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1679531545 PECOS PAC ID: 3870590748 Enrollment ID: I20061107000389 |
| Provider Name | Stephen T Belk |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1942219357 PECOS PAC ID: 7911905567 Enrollment ID: I20061116000035 |
| Provider Name | Juris P Simanis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417901935 PECOS PAC ID: 9830293679 Enrollment ID: I20070403000591 |
| Provider Name | Rhonda J Orrell |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1881713808 PECOS PAC ID: 3072613686 Enrollment ID: I20070712000004 |
| Provider Name | Kelly K. Raney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801963715 PECOS PAC ID: 9931294097 Enrollment ID: I20071004000100 |
| Provider Name | John Gamble |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1174528111 PECOS PAC ID: 8123932241 Enrollment ID: I20080306000683 |
| Provider Name | Kevin M Presley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275720443 PECOS PAC ID: 2264519826 Enrollment ID: I20080407000235 |
| Provider Name | Pamela L Kepus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558492447 PECOS PAC ID: 5991804890 Enrollment ID: I20080521000300 |
| Provider Name | Kristopher J Kaufman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023029998 PECOS PAC ID: 7618977653 Enrollment ID: I20081003000741 |
| Provider Name | Kristina S Kaufmann |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952312282 PECOS PAC ID: 6608875646 Enrollment ID: I20081003000743 |
| Provider Name | Adnan Khalid |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1255369567 PECOS PAC ID: 8628136298 Enrollment ID: I20081027000166 |
| Provider Name | James Gerard Liesen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1003815291 PECOS PAC ID: 5597869057 Enrollment ID: I20081204000341 |
| Provider Name | Paul S Stortz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629268016 PECOS PAC ID: 8628126307 Enrollment ID: I20090511000006 |
| Provider Name | Lisa Annette Stringfellow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982859195 PECOS PAC ID: 3072663772 Enrollment ID: I20090617000490 |
| Provider Name | Donna M Griffin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417160920 PECOS PAC ID: 9234281411 Enrollment ID: I20090720000102 |
| Provider Name | Muhammad Javed Ashraf |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1275690729 PECOS PAC ID: 0446303028 Enrollment ID: I20090729000490 |
| Provider Name | Brad W Jones |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1053570903 PECOS PAC ID: 4587717715 Enrollment ID: I20090805000199 |
| Provider Name | Venkat R Pasnoori |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740236710 PECOS PAC ID: 5890783344 Enrollment ID: I20090806000546 |
| Provider Name | Sherri K Eador |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972753648 PECOS PAC ID: 1254485238 Enrollment ID: I20090811000471 |
| Provider Name | Juan Gustavo Nix |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1508939661 PECOS PAC ID: 6608918230 Enrollment ID: I20100120000799 |
| Provider Name | Marceleen K Powell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538273396 PECOS PAC ID: 6204979214 Enrollment ID: I20100129000486 |
| Provider Name | Dennis M Boeke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205849809 PECOS PAC ID: 1951445972 Enrollment ID: I20100215000390 |
| Provider Name | Malissa B Phillips |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851404776 PECOS PAC ID: 9234265067 Enrollment ID: I20100331000103 |
| Provider Name | Malcolm B Oliver |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730278730 PECOS PAC ID: 3870629645 Enrollment ID: I20100331000490 |
| Provider Name | Kenneth R Smith |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1508979477 PECOS PAC ID: 4082741749 Enrollment ID: I20100428000942 |
| Provider Name | Jennifer L Joy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811210552 PECOS PAC ID: 7719015171 Enrollment ID: I20100506000258 |
| Provider Name | Lauretta M Britz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902901176 PECOS PAC ID: 3779612379 Enrollment ID: I20100519000861 |
| Provider Name | Mandy D Agostino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528384823 PECOS PAC ID: 4385776384 Enrollment ID: I20100709000157 |
| Provider Name | Michael Bruce Loggan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336128552 PECOS PAC ID: 0840347597 Enrollment ID: I20100817001478 |
| Provider Name | Rita Mukerji |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1023218807 PECOS PAC ID: 6305961673 Enrollment ID: I20100910000521 |
| Provider Name | Lori J Cohen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760404230 PECOS PAC ID: 4688582547 Enrollment ID: I20100928001516 |
| Provider Name | Ronald L Vance |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588772248 PECOS PAC ID: 1052229911 Enrollment ID: I20100928001535 |
| Provider Name | Jeffrey R Tedrow |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548282064 PECOS PAC ID: 6507774486 Enrollment ID: I20100928001551 |
| Provider Name | Sara A Neal |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1962540211 PECOS PAC ID: 2062605074 Enrollment ID: I20101022000703 |
| Provider Name | Jeffrey Lynn Dryden |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316923956 PECOS PAC ID: 5991613846 Enrollment ID: I20101028000789 |
| Provider Name | Ronald D Hunziger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306154711 PECOS PAC ID: 5092909374 Enrollment ID: I20101101000162 |
| Provider Name | Joseph Andrew Moore |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1790719417 PECOS PAC ID: 8527952803 Enrollment ID: I20110601000449 |
| Provider Name | Thomas G Douglas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851686182 PECOS PAC ID: 0446428668 Enrollment ID: I20110714000098 |
| Provider Name | Laura C Vance |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225050784 PECOS PAC ID: 2961679626 Enrollment ID: I20120120000100 |
| Provider Name | Louis B Harris |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922018076 PECOS PAC ID: 4789592643 Enrollment ID: I20120120000116 |
| Provider Name | Ronald A Evans |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679595102 PECOS PAC ID: 0143138008 Enrollment ID: I20120120000135 |
| Provider Name | William S Donnell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639191125 PECOS PAC ID: 3870401730 Enrollment ID: I20120120000178 |
| Provider Name | Chastity D Mccullick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477838571 PECOS PAC ID: 7517125081 Enrollment ID: I20120301000295 |
| Provider Name | Chetan Soni |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1598876526 PECOS PAC ID: 3577719947 Enrollment ID: I20120820000238 |
| Provider Name | Troy D Morrison |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1073829925 PECOS PAC ID: 9436329604 Enrollment ID: I20120926000708 |
| Provider Name | Muhammad F Khan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1366575151 PECOS PAC ID: 4183719222 Enrollment ID: I20121004000043 |
| Provider Name | Jane S. Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568710994 PECOS PAC ID: 3870744212 Enrollment ID: I20121113000472 |
| Provider Name | Linda F Houts |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386958932 PECOS PAC ID: 5799937595 Enrollment ID: I20121130000043 |
| Provider Name | Richard C Adams |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1205925427 PECOS PAC ID: 0042210379 Enrollment ID: I20130104000461 |
| Provider Name | Tisha K Joplin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295074615 PECOS PAC ID: 2062650161 Enrollment ID: I20130531000358 |
| Provider Name | Muskinni Olanrewaju Salau |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215167895 PECOS PAC ID: 9931349396 Enrollment ID: I20130708000314 |
| Provider Name | Osamede Edokpolo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326334459 PECOS PAC ID: 2062655723 Enrollment ID: I20130827000958 |
| Provider Name | Sarah B Kallberg |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1285860551 PECOS PAC ID: 4082858915 Enrollment ID: I20130916000667 |
| Provider Name | Shari Pruitt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437498409 PECOS PAC ID: 3173757945 Enrollment ID: I20131009002184 |
| Provider Name | Stephen N Finzo |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1760544381 PECOS PAC ID: 3870737406 Enrollment ID: I20131024001228 |
| Provider Name | Johnna L Brothers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497187439 PECOS PAC ID: 0840426359 Enrollment ID: I20131111001167 |
| Provider Name | Kurt R Bravata |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790096170 PECOS PAC ID: 0547497034 Enrollment ID: I20131206001257 |
| Provider Name | Daniellle M Seiner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851737225 PECOS PAC ID: 4789812405 Enrollment ID: I20140102000021 |
| Provider Name | Stephane M Counts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922356823 PECOS PAC ID: 0345471835 Enrollment ID: I20140326001485 |
| Provider Name | Kelly J Mclemore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609298090 PECOS PAC ID: 7911139167 Enrollment ID: I20140422001776 |
| Provider Name | Jonathan E Gray |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1578798054 PECOS PAC ID: 5597989178 Enrollment ID: I20140623000864 |
| Provider Name | Bryan E Flueckiger |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992705305 PECOS PAC ID: 3870587009 Enrollment ID: I20140811002119 |
| Provider Name | Teresa A Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184037681 PECOS PAC ID: 2860610946 Enrollment ID: I20140903000439 |
| Provider Name | Angela Collins |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1629120506 PECOS PAC ID: 1658599626 Enrollment ID: I20140904001810 |
| Provider Name | Garrett M Alderfer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932424603 PECOS PAC ID: 7810117801 Enrollment ID: I20140925000065 |
| Provider Name | Janet A Ofori-yeboah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740682657 PECOS PAC ID: 0749401909 Enrollment ID: I20141031002066 |
| Provider Name | Mohsin U Qazi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1437461084 PECOS PAC ID: 6507091469 Enrollment ID: I20141205001733 |
| Provider Name | Jerald D Forsyth |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1558451948 PECOS PAC ID: 1456662436 Enrollment ID: I20150617000998 |
| Provider Name | Ruth Pitts |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841554375 PECOS PAC ID: 2264743772 Enrollment ID: I20150624000729 |
| Provider Name | Sateesh K Gunda |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134407844 PECOS PAC ID: 2466764881 Enrollment ID: I20150626001460 |
| Provider Name | Amit C Shah |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689806978 PECOS PAC ID: 3678739984 Enrollment ID: I20150723007568 |
| Provider Name | Ashley M Lane |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1023306388 PECOS PAC ID: 7517273089 Enrollment ID: I20150828000397 |
| Provider Name | Bethany L Dhondt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356782619 PECOS PAC ID: 3072731603 Enrollment ID: I20150910002873 |
| Provider Name | Jessica E Sears |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1265534341 PECOS PAC ID: 5890938096 Enrollment ID: I20151013001884 |
| Provider Name | Jennifer L Follis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205106531 PECOS PAC ID: 5698070027 Enrollment ID: I20160225000560 |
| Provider Name | Robert L Denney |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1245613322 PECOS PAC ID: 4880993658 Enrollment ID: I20160428001548 |
| Provider Name | Kelly M Watson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154711265 PECOS PAC ID: 1951627694 Enrollment ID: I20160504001148 |
| Provider Name | Clarence Findley |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1962644310 PECOS PAC ID: 2062685753 Enrollment ID: I20160713000060 |
| Provider Name | Matthew C Ericksen |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1285956797 PECOS PAC ID: 0042525727 Enrollment ID: I20160810000300 |
| Provider Name | Robin L Bobinmyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023460433 PECOS PAC ID: 2961797683 Enrollment ID: I20160819001486 |
| Provider Name | Tia Renee Phillips |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669926770 PECOS PAC ID: 1850686387 Enrollment ID: I20160823002807 |
| Provider Name | Jocelyn P Morey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902255391 PECOS PAC ID: 2264727395 Enrollment ID: I20160829000194 |
| Provider Name | Brian A Guhl |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114288099 PECOS PAC ID: 2163679291 Enrollment ID: I20161010000297 |
| Provider Name | Gina N Viser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316495492 PECOS PAC ID: 4284913435 Enrollment ID: I20161111000616 |
| Provider Name | Kyla Inman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043760341 PECOS PAC ID: 8022399179 Enrollment ID: I20170103001145 |
| Provider Name | Kristin L Waugh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639544802 PECOS PAC ID: 4284924960 Enrollment ID: I20170109000057 |
| Provider Name | Stephanie L Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457898603 PECOS PAC ID: 6204110851 Enrollment ID: I20170228001044 |
| Provider Name | Bilkisu S Gaye |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780940809 PECOS PAC ID: 1759693914 Enrollment ID: I20170405001857 |
| Provider Name | Kathryn E Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003260472 PECOS PAC ID: 4880962364 Enrollment ID: I20170626001373 |
| Provider Name | Shelby Bailey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730600974 PECOS PAC ID: 0840562021 Enrollment ID: I20170823001177 |
| Provider Name | Ashley Nicole Carpenter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720526692 PECOS PAC ID: 9638442494 Enrollment ID: I20170830002695 |
| Provider Name | Daniel L Skief |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821517293 PECOS PAC ID: 5092071100 Enrollment ID: I20171106002450 |
| Provider Name | Jennifer M Deines |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1366983694 PECOS PAC ID: 3072879741 Enrollment ID: I20171113002953 |
| Provider Name | Daniel J Ferguson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902315401 PECOS PAC ID: 8729345632 Enrollment ID: I20171201000764 |
| Provider Name | Crystal L Pearey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093228850 PECOS PAC ID: 7416215108 Enrollment ID: I20180102000533 |
| Provider Name | Prashanth S Katrapati |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1497941546 PECOS PAC ID: 2567618788 Enrollment ID: I20180102001424 |
| Provider Name | Meghan E Skief |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750894085 PECOS PAC ID: 1951660539 Enrollment ID: I20180108001062 |
| Provider Name | Kenosa Kosicho Okafor |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184967838 PECOS PAC ID: 7315239779 Enrollment ID: I20180123001591 |
| Provider Name | Rachel L Grainger |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316452402 PECOS PAC ID: 0143581546 Enrollment ID: I20180227003187 |
| Provider Name | Heather J Corn |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1396036109 PECOS PAC ID: 5193958957 Enrollment ID: I20180712001379 |
| Provider Name | Christina M Otterness |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1992091284 PECOS PAC ID: 4183970775 Enrollment ID: I20180712001432 |
| Provider Name | Kelsi B Yates |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366934069 PECOS PAC ID: 8820344377 Enrollment ID: I20180713000373 |
| Provider Name | Olivia J Cumley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194211664 PECOS PAC ID: 6507113701 Enrollment ID: I20180719000330 |
| Provider Name | Ryan E Denney |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1437496197 PECOS PAC ID: 6204185721 Enrollment ID: I20180816002020 |
| Provider Name | Patrick J Lowry |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679555114 PECOS PAC ID: 0648520692 Enrollment ID: I20180912001978 |
| Provider Name | Lauren Nicole Argo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679049480 PECOS PAC ID: 0244583565 Enrollment ID: I20181101003293 |
| Provider Name | Austin C Knott |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396164125 PECOS PAC ID: 2466765946 Enrollment ID: I20181221002250 |
| Provider Name | Philipp Alexander Wiesner |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1609162817 PECOS PAC ID: 8224371885 Enrollment ID: I20190522001650 |
| Provider Name | Trace Heavener |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1841646726 PECOS PAC ID: 8224319181 Enrollment ID: I20190719000075 |
| Provider Name | Daniel W Lovinger |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1598115693 PECOS PAC ID: 8123310091 Enrollment ID: I20190805000851 |
| Provider Name | Aneel Ursani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982085676 PECOS PAC ID: 3577863232 Enrollment ID: I20190816000088 |
| Provider Name | Muhammad Sohaib Qamar |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1306291976 PECOS PAC ID: 3678811155 Enrollment ID: I20190827001985 |
| Provider Name | Kimberly D Doolin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982171625 PECOS PAC ID: 3678804127 Enrollment ID: I20191014003131 |
| Provider Name | Kaylee J Ankrom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104474741 PECOS PAC ID: 6406188994 Enrollment ID: I20191104000053 |
| Provider Name | Kristin P Robidou |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639564404 PECOS PAC ID: 4587096904 Enrollment ID: I20191122001392 |
| Provider Name | Nicole L Baker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013550482 PECOS PAC ID: 2860826088 Enrollment ID: I20191221000503 |
| Provider Name | Abby L Chilton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396389466 PECOS PAC ID: 0547698383 Enrollment ID: I20200310001544 |
| Provider Name | Assad Mukhtar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1609259001 PECOS PAC ID: 7315240876 Enrollment ID: I20200331003001 |
| Provider Name | Sarah Geltmacher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174157879 PECOS PAC ID: 6901235068 Enrollment ID: I20200411000467 |
| Provider Name | Jennifer L Gamber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225660228 PECOS PAC ID: 3779912852 Enrollment ID: I20200413000528 |
| Provider Name | Robert L Coffman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1306190913 PECOS PAC ID: 1153752076 Enrollment ID: I20200510000183 |
| Provider Name | Gina Dill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871114058 PECOS PAC ID: 4486076304 Enrollment ID: I20200623002418 |
| Provider Name | Melanie N Beckham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669097119 PECOS PAC ID: 3971925587 Enrollment ID: I20200626000328 |
| Provider Name | William E Hafer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194340547 PECOS PAC ID: 5991129702 Enrollment ID: I20200702000619 |
| Provider Name | Courtney Brummel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164074175 PECOS PAC ID: 7416370440 Enrollment ID: I20200709002738 |
| Provider Name | Creighton B Woolsey |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1144753492 PECOS PAC ID: 5799108445 Enrollment ID: I20200714000868 |
| Provider Name | Kayla B Kittle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437679560 PECOS PAC ID: 9931526605 Enrollment ID: I20200826000852 |
| Provider Name | Taylor N Pedersen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043740202 PECOS PAC ID: 4284978420 Enrollment ID: I20200915003381 |
| Provider Name | Seong-wook Seo |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1104213180 PECOS PAC ID: 5799091245 Enrollment ID: I20200930001895 |
| Provider Name | Mylhan Ih Myers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639699747 PECOS PAC ID: 5890067441 Enrollment ID: I20201001000867 |
| Provider Name | Cassandre D Viets |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720603459 PECOS PAC ID: 4587084710 Enrollment ID: I20201008003605 |
| Provider Name | Shelly A Sorden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851999437 PECOS PAC ID: 0446660278 Enrollment ID: I20201106001955 |
| Provider Name | Michelle Marie Sanborn |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1891933792 PECOS PAC ID: 9032101985 Enrollment ID: I20201118001832 |
| Provider Name | Stephen V Davis |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1124026588 PECOS PAC ID: 7517911399 Enrollment ID: I20210112001933 |
| Provider Name | Abul K Ahsan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376711044 PECOS PAC ID: 0143305185 Enrollment ID: I20210113000614 |
| Provider Name | Nicholas Allen Locke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841889854 PECOS PAC ID: 1153734843 Enrollment ID: I20210120000788 |
| Provider Name | Jason S Okuhara |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1215158456 PECOS PAC ID: 4385684539 Enrollment ID: I20210302003207 |
| Provider Name | Zachary Treat |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447743083 PECOS PAC ID: 0648525386 Enrollment ID: I20210308000707 |
| Provider Name | Benjamin Eric Nelson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558863464 PECOS PAC ID: 8123422383 Enrollment ID: I20210810002192 |
| Provider Name | Haris Riaz |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1689081069 PECOS PAC ID: 2163843418 Enrollment ID: I20210819001419 |
| Provider Name | Lynae R Friend |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831768555 PECOS PAC ID: 6002211372 Enrollment ID: I20210825000350 |
| Provider Name | Michael W Etches |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366962730 PECOS PAC ID: 0547666166 Enrollment ID: I20210908000663 |
| Provider Name | Jamie Lynn Carter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134870173 PECOS PAC ID: 9234516279 Enrollment ID: I20220513000629 |
| Provider Name | Cynthia Appel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932867900 PECOS PAC ID: 3375920770 Enrollment ID: I20220524000549 |
| Provider Name | Justin W Reed |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1487186839 PECOS PAC ID: 8729402441 Enrollment ID: I20220816000857 |
| Provider Name | Linda M Shoemaker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891242715 PECOS PAC ID: 7113394842 Enrollment ID: I20221109000467 |
| Provider Name | Ashley M Batson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184358947 PECOS PAC ID: 8527435262 Enrollment ID: I20221109000683 |
| Provider Name | Ryan A Kedzie |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457814154 PECOS PAC ID: 0345579934 Enrollment ID: I20221110000503 |
| Provider Name | Tara Billingslea |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477275113 PECOS PAC ID: 9436527603 Enrollment ID: I20221118000786 |
| Provider Name | Kyli A Stump |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881349629 PECOS PAC ID: 2961870191 Enrollment ID: I20221119000452 |
| Provider Name | Murphy Remsen Mastin |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1588159917 PECOS PAC ID: 9931457959 Enrollment ID: I20221119000458 |
| Provider Name | Stephen Craig Morris |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1689028417 PECOS PAC ID: 3577967603 Enrollment ID: I20221121000501 |
| Provider Name | Kayla D Cumpton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962027862 PECOS PAC ID: 5092185306 Enrollment ID: I20230103001087 |
| Provider Name | Julia Magdici |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720569924 PECOS PAC ID: 2264786151 Enrollment ID: I20230111000476 |
| Provider Name | Julie Christina Henson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477912731 PECOS PAC ID: 4486947900 Enrollment ID: I20230720002881 |
| Provider Name | Katherine A Davis |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1649731977 PECOS PAC ID: 3870823669 Enrollment ID: I20230816000838 |
| Provider Name | Courtney M Desouza |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255957163 PECOS PAC ID: 9032572631 Enrollment ID: I20230830001038 |
| Provider Name | Brian Robinson |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1821063413 PECOS PAC ID: 7113926197 Enrollment ID: I20230913000821 |
| Provider Name | Linzi R Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154002707 PECOS PAC ID: 9537513700 Enrollment ID: I20230922000917 |
| Provider Name | April C Donovan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114044294 PECOS PAC ID: 3476654716 Enrollment ID: I20231220003126 |
| Provider Name | Nicole A Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437932746 PECOS PAC ID: 7113379892 Enrollment ID: I20240118000981 |
| Provider Name | Allyssa D Dedmon |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407509896 PECOS PAC ID: 4385097906 Enrollment ID: I20240131001463 |
| Provider Name | Dawnielle L Robinson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1144377417 PECOS PAC ID: 8628421245 Enrollment ID: I20240131001576 |
| Provider Name | Nicole M Twenter |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1023781564 PECOS PAC ID: 0941643274 Enrollment ID: I20240203000126 |
| Provider Name | James M Lowery |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306249016 PECOS PAC ID: 5799128690 Enrollment ID: I20240207003895 |
| Provider Name | Kimberly D Ferrell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1598003329 PECOS PAC ID: 2062856396 Enrollment ID: I20240214004118 |
| Provider Name | Julie R Mitchell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174705701 PECOS PAC ID: 4981048170 Enrollment ID: I20240215001808 |
| Provider Name | Edward Lee Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497376107 PECOS PAC ID: 7810355435 Enrollment ID: I20240402001405 |
| Provider Name | Kaisha R Hooper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972366524 PECOS PAC ID: 3274971445 Enrollment ID: I20240406000181 |
Citizens Memorial Hospital District Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1500 N Oakland Ave, Bolivar, MO 65613 Phone: 417-326-6000 | |
Family Institute Of The Ozarks Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 315 S Main Ave, Bolivar, MO 65613 Phone: 417-326-2902 Fax: 417-326-4555 | |
Free Your Mind Therapy Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 910 E San Martin St Ofc 2, Bolivar, MO 65613 Phone: 417-414-0676 Fax: 844-222-4909 | |
New Way Psychological Services Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 711 N Market Ave, Bolivar, MO 65613 Phone: 417-399-1793 | |
Trident Counseling Consulting & Wellness Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 112 W Broadway St St A, Bolivar, MO 61653 Phone: 417-631-3246 | |
New Medico Healthcare Corporation Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3361 S Springfield Ave, Bolivar, MO 65613 Phone: 417-777-1182 Fax: 417-777-1183 | |
Oasis Counseling And Education, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1459 E. Broadway, Bolivar, MO 65613 Phone: 417-327-5184 Fax: 417-777-2650 |