Healthcare Provider Details

I. General information

NPI: 1265628457
Provider Name (Legal Business Name): HELEN LITTLE OKE-THOMAS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2007
Last Update Date: 01/30/2023
Certification Date: 01/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 E REPUBLIC RD
SPRINGFIELD MO
65804-7209
US

IV. Provider business mailing address

1220 E REPUBLIC RD
SPRINGFIELD MO
65804-7209
US

V. Phone/Fax

Practice location:
  • Phone: 866-389-2727
  • Fax:
Mailing address:
  • Phone: 866-389-2727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN115001
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: