Healthcare Provider Details

I. General information

NPI: 1215026745
Provider Name (Legal Business Name): DENISE L SUTTON CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DENISE L LAMBERT

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 02/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3250 GORDONVILLE RD SUITE 358
CAPE GIRARDEAU MO
63703-5056
US

IV. Provider business mailing address

PO BOX 843225
KANSAS CITY MO
64184-3225
US

V. Phone/Fax

Practice location:
  • Phone: 573-331-3155
  • Fax: 573-331-5096
Mailing address:
  • Phone: 708-633-1234
  • Fax: 708-342-7100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License Number144174
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: