Healthcare Provider Details

I. General information

NPI: 1689350019
Provider Name (Legal Business Name): KOURTNEY BUHLER DNP-FNP, APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KOURTNEY ASHTON DNP

II. Dates (important events)

Enumeration Date: 06/22/2023
Last Update Date: 10/25/2023
Certification Date: 10/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 W 10TH ST
ROLLA MO
65401-2905
US

IV. Provider business mailing address

1050 W 10TH ST
ROLLA MO
65401-2905
US

V. Phone/Fax

Practice location:
  • Phone: 573-364-9000
  • Fax: 573-202-2420
Mailing address:
  • Phone: 573-364-9000
  • Fax: 573-202-2484

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2023024479
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: