Healthcare Provider Details

I. General information

NPI: 1710383559
Provider Name (Legal Business Name): LINDSEY M TEEL FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2014
Last Update Date: 02/14/2023
Certification Date: 02/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3415 MCINTOSH CIR
JOPLIN MO
64804-3651
US

IV. Provider business mailing address

PO BOX 3810
JOPLIN MO
64803-3810
US

V. Phone/Fax

Practice location:
  • Phone: 417-347-4000
  • Fax: 417-347-4064
Mailing address:
  • Phone: 417-347-6605
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2014039309
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: