MEDICARE: DANA S DRISKELL ARNP

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	054128	MO

General Provider Information

NPI Number	:	1568483188
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANA S DRISKELL ARNP

Provider Business Mailing Address
First Line	:	206 NW MOCK AVE
Second Line	:
City	:	BLUE SPRINGS
State	:	MO
Zip	:	64014-2507
Country	:	US
Telephone Number	:	816-229-1198
Fax Number	:	816-229-1198

Provider Business Practice Location Address
First Line	:	206 NW MOCK AVE
Second Line	:	SUITE 100
City	:	BLUE SPRINGS
State	:	MO
Zip	:	64014-2507
Country	:	US
Telephone Number	:	816-229-1191
Fax Number	:	816-229-1198

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

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	12/11/2012

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