MEDICARE: BARBARA ATKINSON FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	2012002554	MO

General Provider Information

NPI Number	:	1407112121
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA ATKINSON FNP

Provider Business Mailing Address
First Line	:	5601 NE ANTIOCH RD
Second Line	:	STE 4
City	:	GLADSTONE
State	:	MO
Zip	:	64119-2328
Country	:	US
Telephone Number	:	816-452-4488
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 W CHESTNUT ST
Second Line	:
City	:	BUTLER
State	:	MO
Zip	:	64730-1554
Country	:	US
Telephone Number	:	660-679-3149
Fax Number	:	660-679-3468

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2012
Last Update Date	:	02/26/2019

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