Healthcare Provider Details

I. General information

NPI: 1093046534
Provider Name (Legal Business Name): JAMIE M ZURCHER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. JAMIE M CROWL

II. Dates (important events)

Enumeration Date: 01/22/2010
Last Update Date: 05/08/2023
Certification Date: 05/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 N MAIN ST
GRAVOIS MILLS MO
65037-6253
US

IV. Provider business mailing address

PO BOX 777
RICHLAND MO
65556-0777
US

V. Phone/Fax

Practice location:
  • Phone: 877-406-2662
  • Fax:
Mailing address:
  • Phone: 877-406-2662
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2022035978
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2004019008
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: