Healthcare Provider Details

I. General information

NPI: 1912245887
Provider Name (Legal Business Name): CHRIS LELAND WIER F.N.P.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2013
Last Update Date: 03/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 STATE ST
LEXINGTON MO
64067-1107
US

IV. Provider business mailing address

1500 STATE ST
LEXINGTON MO
64067-1107
US

V. Phone/Fax

Practice location:
  • Phone: 660-259-2203
  • Fax: 660-259-6819
Mailing address:
  • Phone: 660-259-2203
  • Fax: 660-259-6819

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2013004944
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number2010001428
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: