Healthcare Provider Details

I. General information

NPI: 1881048593
Provider Name (Legal Business Name): DAYANA ARTEAGA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2016
Last Update Date: 10/26/2023
Certification Date: 10/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1423 N JEFFERSON AVE
SPRINGFIELD MO
65802-1917
US

IV. Provider business mailing address

PO BOX 802843
KANSAS CITY MO
64180-2208
US

V. Phone/Fax

Practice location:
  • Phone: 417-269-6891
  • Fax: 417-269-5595
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number2020042920
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number6134
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: