Healthcare Provider Details

I. General information

NPI: 1720779143
Provider Name (Legal Business Name): KRISTINA KATHERINE KORBESMEYER RRT/ RCP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2023
Last Update Date: 05/17/2023
Certification Date: 05/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 W SUNSHINE ST
SPRINGFIELD MO
65807-2240
US

IV. Provider business mailing address

1900 W SUNSHINE ST
SPRINGFIELD MO
65807-2240
US

V. Phone/Fax

Practice location:
  • Phone: 417-862-7041
  • Fax:
Mailing address:
  • Phone: 417-862-7041
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number2013004558
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: