Healthcare Provider Details

I. General information

NPI: 1295498699
Provider Name (Legal Business Name): NANCY P STAUFFER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/21/2021
Last Update Date: 04/12/2024
Certification Date: 04/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3151 LITTON RD
CHILLICOTHEE MO
64601-8502
US

IV. Provider business mailing address

1600 E EVERGREEN ST
CAMERON MO
64429-2400
US

V. Phone/Fax

Practice location:
  • Phone: 660-646-4032
  • Fax: 660-646-1217
Mailing address:
  • Phone: 816-632-2101
  • Fax: 816-649-3383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2021041121
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: