Healthcare Provider Details

I. General information

NPI: 1962420802
Provider Name (Legal Business Name): CYNTHIA N DANCEY PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 08/18/2021
Certification Date: 08/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5100 N TOWNE CENTRE DR
OZARK MO
65721-7479
US

IV. Provider business mailing address

PO BOX 802843
KANSAS CITY MO
64180-2843
US

V. Phone/Fax

Practice location:
  • Phone: 417-269-2215
  • Fax: 417-269-2427
Mailing address:
  • Phone: 417-730-6430
  • Fax: 417-269-7567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number2003007572
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: