Healthcare Provider Details

I. General information

NPI: 1891057964
Provider Name (Legal Business Name): TONI R MCGINNIS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TONI R COZAD NP

II. Dates (important events)

Enumeration Date: 06/13/2012
Last Update Date: 06/12/2024
Certification Date: 04/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 N ASH ST
BUFFALO MO
65622-8590
US

IV. Provider business mailing address

PO BOX 505673
SAINT LOUIS MO
63150-5673
US

V. Phone/Fax

Practice location:
  • Phone: 417-269-2200
  • Fax: 417-269-2202
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2012016687
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: