Healthcare Provider Details

I. General information

NPI: 1528907300
Provider Name (Legal Business Name): EMILY MINA AUSTIN APRN, FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 E 50TH ST
JOPLIN MO
64804-4920
US

IV. Provider business mailing address

1 CONGLETON LN
BELLA VISTA AR
72714-4504
US

V. Phone/Fax

Practice location:
  • Phone: 417-556-3400
  • Fax:
Mailing address:
  • Phone: 501-650-3614
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2026014637
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: