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NPI Code Detail

MEDICARE: MS. IDA N JUNGE FNP

MEDICARE:  MS. IDA N JUNGE  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
1363LF0000XFamily Nurse Practitioner071921MO

General Provider Information

NPI Number : 1841283868
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. IDA N JUNGE FNP
Provider Business Mailing Address
First Line : PO BOX 1359
Second Line :
City : AVA
State : MO
Zip : 65608-1359
Country : US
Telephone Number : 417-683-5739
Fax Number :
Provider Business Practice Location Address
First Line : 504 NW 10TH AVE.
Second Line :
City : AVA
State : MO
Zip : 65608-1359
Country : US
Telephone Number : 417-683-5739
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2005
Last Update Date : 02/07/2014

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Directions to “ MS. IDA N JUNGE FNP” Practice Location

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