Healthcare Provider Details

I. General information

NPI: 1740084938
Provider Name (Legal Business Name): JESSICA STEAKLEY FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2025
Last Update Date: 05/22/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3105 MCCLELLAND BLVD
JOPLIN MO
64804-1640
US

IV. Provider business mailing address

932 E 34TH ST
JOPLIN MO
64804-3932
US

V. Phone/Fax

Practice location:
  • Phone: 417-347-5400
  • Fax: 417-347-5709
Mailing address:
  • Phone: 417-347-3664
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number2025009733
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2025009733
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: