Healthcare Provider Details

I. General information

NPI: 1265367262
Provider Name (Legal Business Name): MARIA ADAH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1513 UNION AVE STE 2500
MOBERLY MO
65270-9412
US

IV. Provider business mailing address

4415 MAXWELL LN
COLUMBIA MO
65203-6569
US

V. Phone/Fax

Practice location:
  • Phone: 660-372-1313
  • Fax: 660-372-1339
Mailing address:
  • Phone: 573-239-0660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2026014781
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: