Healthcare Provider Details

I. General information

NPI: 1114816782
Provider Name (Legal Business Name): JENNIFER KARGEL MSN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2025
Last Update Date: 10/17/2025
Certification Date: 10/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 S NATIONAL AVE STE 400
SPRINGFIELD MO
65807-5272
US

IV. Provider business mailing address

200 FOX RIDGE RD
BRANSON MO
65616-9799
US

V. Phone/Fax

Practice location:
  • Phone: 417-269-9482
  • Fax:
Mailing address:
  • Phone: 417-699-2209
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number2025020695
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: