Healthcare Provider Details

I. General information

NPI: 1356338933
Provider Name (Legal Business Name): LETA J BARNES PNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LETA J HOHL PNP

II. Dates (important events)

Enumeration Date: 09/29/2005
Last Update Date: 03/21/2025
Certification Date: 03/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3925 W RANDALL ST
BATTLEFIELD MO
65619-8303
US

IV. Provider business mailing address

3925 W RANDALL ST
BATTLEFIELD MO
65619-8303
US

V. Phone/Fax

Practice location:
  • Phone: 417-830-7728
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number099455
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: