Healthcare Provider Details

I. General information

NPI: 1801133343
Provider Name (Legal Business Name): STEPHANIE KIRSTEN VOORHIS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2013
Last Update Date: 04/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3231 S NATIONAL AVE STE 140
SPRINGFIELD MO
65807-7304
US

IV. Provider business mailing address

PO BOX BPX # 505164
SAINT LOUIS MO
63150-5164
US

V. Phone/Fax

Practice location:
  • Phone: 417-890-4132
  • Fax:
Mailing address:
  • Phone: 417-829-4620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2013000126
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: