Healthcare Provider Details

I. General information

NPI: 1255767828
Provider Name (Legal Business Name): ANNETTE VORHOFF APN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2013
Last Update Date: 10/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 SUNNY LANE 360 DEGREE MEDICINE
BRANSON MO
65737
US

IV. Provider business mailing address

465 COUNTY ROAD 155
EUREKA SPRINGS AR
72632-9698
US

V. Phone/Fax

Practice location:
  • Phone: 417-598-1408
  • Fax:
Mailing address:
  • Phone: 479-253-7528
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA003970
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: