Healthcare Provider Details

I. General information

NPI: 1154599900
Provider Name (Legal Business Name): DANNY LEE GARTON FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2008
Last Update Date: 05/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 PORTER AVE
AURORA MO
65605-2365
US

IV. Provider business mailing address

500 PORTER AVE
AURORA MO
65605-2365
US

V. Phone/Fax

Practice location:
  • Phone: 417-678-2122
  • Fax: 417-678-7841
Mailing address:
  • Phone: 417-678-2122
  • Fax: 417-678-7841

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2000148465
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: