Healthcare Provider Details

I. General information

NPI: 1760834378
Provider Name (Legal Business Name): SHEENA CAITLYN PAINTER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS SHEENA CAITLYN MURPHY

II. Dates (important events)

Enumeration Date: 07/07/2016
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1337 S SAM HOUSTON BLVD
HOUSTON MO
65483-2046
US

IV. Provider business mailing address

1337 S SAM HOUSTON BLVD
HOUSTON MO
65483-2046
US

V. Phone/Fax

Practice location:
  • Phone: 417-967-5435
  • Fax: 417-967-5503
Mailing address:
  • Phone: 417-967-5435
  • Fax: 417-967-5503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2016023380
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: