Healthcare Provider Details
I. General information
NPI: 1881093979
Provider Name (Legal Business Name): OZARKS AREA COMMUNITY ACTION CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/14/2014
Last Update Date: 06/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
215 S. BARNES AVE
SPRINGFIELD MO
65802-2204
US
IV. Provider business mailing address
215 S. BARNES AVE
SPRINGFIELD MO
65802-2204
US
V. Phone/Fax
- Phone: 417-864-3410
- Fax: 417-864-3416
- Phone: 417-864-3410
- Fax: 417-864-3416
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP2300X |
| Taxonomy | Primary Care Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JENNIFER
LYNN
OLSON
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 417-862-4314