Healthcare Provider Details

I. General information

NPI: 1639318314
Provider Name (Legal Business Name): BARBARA JANE KUZARA APMHNP - BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2009
Last Update Date: 01/31/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 E 32ND ST
JOPLIN MO
64804-3312
US

IV. Provider business mailing address

1002 MCINTOSH CIR
JOPLIN MO
64804-3642
US

V. Phone/Fax

Practice location:
  • Phone: 417-347-7567
  • Fax:
Mailing address:
  • Phone: 417-347-7569
  • Fax: 417-347-7566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2010025025
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: