Healthcare Provider Details

I. General information

NPI: 1649830290
Provider Name (Legal Business Name): STEPHANIE RENEE MCGARITY FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: STEPHANIE ARNOLD

II. Dates (important events)

Enumeration Date: 06/17/2019
Last Update Date: 06/25/2020
Certification Date: 06/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2240 W SUNSET ST STE 104
SPRINGFIELD MO
65807-6041
US

IV. Provider business mailing address

PO BOX 802843
KANSAS CITY MO
64180-2843
US

V. Phone/Fax

Practice location:
  • Phone: 417-269-4663
  • Fax: 417-269-0692
Mailing address:
  • Phone: 417-269-5712
  • Fax: 417-269-7567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number2019011364
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: