Healthcare Provider Details

I. General information

NPI: 1639168230
Provider Name (Legal Business Name): STEVEN R BARNES FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2005
Last Update Date: 07/28/2022
Certification Date: 07/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 S MAIN ST
ROGERSVILLE MO
65742-9357
US

IV. Provider business mailing address

101 S MAIN ST
ROGERSVILLE MO
65742-9357
US

V. Phone/Fax

Practice location:
  • Phone: 417-753-9404
  • Fax: 417-753-9137
Mailing address:
  • Phone: 417-753-9404
  • Fax: 417-753-9137

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number123392
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: