Healthcare Provider Details

I. General information

NPI: 1558140178
Provider Name (Legal Business Name): CHRISTINE JO WARDEN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2023
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 VFW RD
ELDON MO
65026-4685
US

IV. Provider business mailing address

PO BOX 25
ELDON MO
65026-0025
US

V. Phone/Fax

Practice location:
  • Phone: 573-673-6971
  • Fax:
Mailing address:
  • Phone: 573-673-6971
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number2010004612
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number2010004612
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: