Healthcare Provider Details

I. General information

NPI: 1104782754
Provider Name (Legal Business Name): MERRIE CHRISTEN KANDLBINDER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MERRIE CHRISTEN BUCKMASTER FNP

II. Dates (important events)

Enumeration Date: 12/29/2025
Last Update Date: 12/29/2025
Certification Date: 12/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1516 S NATIONAL AVE
SPRINGFIELD MO
65804-1120
US

IV. Provider business mailing address

1516 S NATIONAL AVE
SPRINGFIELD MO
65804-1120
US

V. Phone/Fax

Practice location:
  • Phone: 417-860-0395
  • Fax:
Mailing address:
  • Phone: 417-860-0395
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number2025037976
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: