Healthcare Provider Details

I. General information

NPI: 1437428398
Provider Name (Legal Business Name): ADVANCED PROVIDER SERVICES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2011
Last Update Date: 12/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 E MARKET ST
BATES CITY MO
64011-9745
US

IV. Provider business mailing address

901 S SPRUCE ST
BATES CITY MO
64011-9707
US

V. Phone/Fax

Practice location:
  • Phone: 816-896-0416
  • Fax: 816-690-3147
Mailing address:
  • Phone: 816-896-0416
  • Fax: 816-690-3147

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number104126
License Number StateMO

VIII. Authorized Official

Name: MRS. ANGELA JO HILBRENNER
Title or Position: OWNER/NURSE PRACTITIONER
Credential: FNP-C
Phone: 816-896-0416