Healthcare Provider Details

I. General information

NPI: 1962949115
Provider Name (Legal Business Name): ALLISON CHAMBERLIN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2017
Last Update Date: 01/14/2022
Certification Date: 01/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1423 N JEFFERSON AVE # B100
SPRINGFIELD MO
65802-1917
US

IV. Provider business mailing address

PO BOX 802843
KANSAS CITY MO
64180-2843
US

V. Phone/Fax

Practice location:
  • Phone: 417-269-8817
  • Fax: 417-269-8744
Mailing address:
  • Phone: 417-730-6430
  • Fax: 417-269-7567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2017002552
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: