Healthcare Provider Details

I. General information

NPI: 1982447702
Provider Name (Legal Business Name): RIVERBRANCH HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2024
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

281 US HIGHWAY 60 W
REPUBLIC MO
65738-1432
US

IV. Provider business mailing address

281 US HIGHWAY 60 W
REPUBLIC MO
65738-1432
US

V. Phone/Fax

Practice location:
  • Phone: 417-501-9042
  • Fax: 417-708-0815
Mailing address:
  • Phone: 417-501-9042
  • Fax: 417-708-0815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SARA B. MCCALLEY
Title or Position: FNP-C/OWNER
Credential: FNP-C
Phone: 417-501-9042